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HomeMy WebLinkAbout0099712-ElectricOSHKOSH ON THE WATER .lob Address 3234 BELLFIELD DR Contractor VAN ERT ELECTRIC Service [~ New (~ Change Volts 120/240 CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner CREATIVE CUSTOM HOMES & DEVELOP I Category 611 - Residential-New Single Family Wiring Amps 200 ~ Temp Type I~ Overhead Circuits 18 Switches 30 No 99712 Create Date 02/03/2003 Plan ~ Underground Fixtures Receptacles 17 60 Appliances Range, Dishwasher, Garbage Disposal, Dryer, Fan or Blower & Furnace. Use/Nature of NSFR/Wire new home. *Job #F1512-CN. Work Fees: Valuation Issued By: $4,500.00 Plan Approval $0.00 Permit Fee Paid $105.00 Date 02/06/2003 Permit Voided In the performance of this work I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 2000 PROGRESS WAY KAUKUANA WI 54130 - 0 Telephone Number 920-766-3888 02/06/02 \ l{ 09:51 FAX 920 766 0883 VAN ERT ELECTRIC ~003/009 City ot'oshkosh Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5054 ELECTRICAL PERMIT APPLICATION All information after bold categories must b¢ provided, Incomplete applicalions will not bc processed. O/H OYH · Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus' normal permit fc~, which ever is greater. OR- ' are a contractor partici~ati_n£ i~ the Perr~t ~_ee Acc. ount System and hav¢.a(lequate funds, check h. If.if gouYO]~ wan~this procesre-d through Four account/~ co r cro CHECK [~ ALL APPLICABLE ngCATEGORY le Family I-IDupl~x E]Multi-Family SERVICE~ew QTemporasy ElChange EINot Applicable [-IRental UICommercial IZlIndustrial TYPE [3Overhead ElNot Applicable ndcrground FILL IN THE APPROPRIATE BLANK WITH THI~ NUMBER Circuits# CHRCK [B ALL APPLICABLE  Range ~. ishwashcr ,~'"~arbage Disposal an OR. Blower /g4~umace I-1AJC IZIMotors EIGas Pumps ~Other .scxnmo ALL ....... f, O iV ' EIEteciric Sign ElWater Heater VALUE (Including labor an~ all materials including light fixtures) $ ~Z~s ff~). ''''~ MASTER ELECTRICIAN