HomeMy WebLinkAboutElectric Note - 08/19/2005
Contractor
Job A<ldre~s 715 JEFFERSON ST
Service
Volts
Amps
Appliances
CSI ELECTRIC
0 New
0
City of Oshkosh Electric Note
Owner KYLE A HENDERSON
Create Date 08/19/2005
Category 612 - Residential-Single Family Addltion/R
Plan
0 Change
0 Temp
0 Overhead
0 Underground
Type
0
Fixtures
Circuits
Switches 0
Receptacles
Use/Nature of EIV submitted for reconnection or new circuit for the replacement of other permanenetley wired appliances / fixtures. for work done by
Work Paul Davis Restoration.
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CilyofOshkosh
D;v;s;oo oflos!,,";OO Sm-;oes
215 Ch""h Av,"ue
POB" 1130
Oshkosh WI 54903-1130
om" 920-236-5050
F.x 920.236-5084
AUG 1 62005
Electric Installation
I (We)
C,:5,Þ.
Ei&cIR¡"(' (CCMce¡)f5?tPv¡Cð +~c)
(Electrical Contractor Name)
t.Jõ 3~3
(Address)
f/L.lV 57
/
~ /et2e
(City)
VI
(State)
PAuL ]Mví5 R(').:)1()¡ê!lf/oAl
(Name of party contracted to)
.JJ./tÚ
(Zip Code)
have been contracted to perform electric installation work for
at the following address:
7/') 5, JeFF(? (2.'50/11 sf
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
- Reconnection or new circuit for replacement Heating Plant and/or AlC Condenser.
- ReconIlection or new circuit for replacement Electric Water Heater or powêr vented
water heater.
- Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit. .
--A Reconnection or.new circuit for the replacement of other permanently wired
appliances / fixtures.
- New circuit for the addition of AlC to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $
110.00 .
I hereby verify this work will be performed by an employee ofthis company and further verify
Q::æJ5 will be done in oompliwoe willi rowu'""",,, "'" Electrio """
(L.. ~f ~ '¡f- is-oS
(Signature of Company Officer) (Print Name of Officer) (Date)
5/02