HomeMy WebLinkAbout0117297-HVAC (furnace/chimney liner)
NOV. 8.<::005
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WITZKE ELECTRIC
NO. 31<::
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Electric Installation Verification
I(We) \¡\Ii-\-yk~ S{e6lJ\c, Inc.
(Electrical Contrector Name)
)55 E. l?o.c.k.er Av€J)\.J~ Oshk.osh wr. &fqo (
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for(j¡¡,~ T()jJll'mnhrt
(Name of party contrected to)
at the following address: ~1 frd/¡ljicl" SltRd
(Address where work will be performed)
The nature ofilie woIk consists of: (Check One or Describe the Nature of Work)
-X- Reconnection or new circuit for replacement Heating P1ant andJor AlC Condenser.
- Reconnection or new circuit for replacement Electric Wat~r Heater or power vented
water heater.
- Reconnectlon of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting £Ï¡ctures due to siding I soffit installation. Note: New Service
Entrance Cables will require a separate permk
- Reconnection or new circuit for the replacement of other pen:nanently wired
appnances / fixtures.
~ New circuit for the addition of AlC to an indtviduo.l dwelling unit (house or the
individual systems in 1\ duplex or condominium), including required service
electrical outlets.
Other
The value oftbis work is $ /(f),oo
I hereby verify this work will be peribrmed by an employee of this company aJ1d furt.'ler verify
the reconnection J installation will be done in compliance with manufacturer and Electric code
requirements.
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(Signature of Company Officer)
~'r'\ a\~
(Print Name of Officer)
II-f-Ob
(Date)
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