HomeMy WebLinkAbout0091216-Electric (misc)
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OSHKOSH
ON THE WATER
Job Address 2466 BLAKE CT
CITY OF OSHKOSH
No 91216
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner HERITAGE HOMES OF OSHKOSH INC Create Date 11/09/2001
Contractor CUMINGS ELECTRIC
Category 612 - Residential-Single Family Addition/R Plan
Service
b New
o Change
o Temp
Type 0 Overhead
o Underground
Volts
Circuits
Fixtures
Amps
Switches
Receptacles
Appliances Dryer
Use/Nature of SFRI Add recp.s, lights, switches and circuits. 'Job 4139
Work
Fees: Valuation
$500.00
Plan Approval
$0.00
Permit Fee Paid
Issued By:
KM
$20.00
Date 11/09/2001
D Permit Voided I
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
AgenUOwner
Address
PO BOX 749 1414 COUNTY RD JJ
NEENAH
WI 54957 - 749
Telephone Number 231-5946 (Dick) 585-501
1"
If)
Nov 09 01 07:50a
eEl
920 722 0769
p. 1
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OJH<OfH
DI't l}1!: V.I^ft:;;R.
Division of Inspection Se~vices
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
Phone (920) 236-5046
ELE€TRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incol!lplete applications. will not be processed.
DATE 11/09/01
JOB ADDRESS 2466 BLAKE CRT.
OWNER KEN LUNN1NG
CONTRACTOR CUMINGS ELECTRIC INC.
,
JOB NO. 4139
CHECK ALL APPLICABLE
USE CATEGORY: SINGLE FA.1IiJILYrg}
COMMERCIALO
SERVICE; NEW 0 CHANGE 0
DUPLEXO M(JLTI-F~ILYO RENTALO
INDUSTRIALD
TEMPORARY 0 NOT APPLICABLE []
TYPE:
OVERHEAD 0
UNDERGR0UND'[]
NQT APPLICABLE []
NUMBER OF FIXTURES X SWITCHES ~ RECEPTACL~S ~ CIRCUITS ~
AMPS
VOLTS L
PHASE
CHECK ALL APPLICABLE
RANGE 0 WATER HEATER 0 GARBAGE DISPOSAL.rr DRYER rg]
DISHWASHER 0 FAN ORB-LOWBRO FURNACE [] AIC 0
ELECTRIC SIGN 0 MOTORS- 0 GAS PUMPS q OTHER
DESCRIPTION OF ALL WORK BEING DONE ADD RECEPTS, LIGHTS. SWITCHES, CIRCUITS
VALUE (I~~'Ud.ing l.aborand- al.l:mate-rials including light fixtures) $500.00
PEMofI'l' FEE: r ::;J.C, "1':
MASTER ELECTRICIAN RICHARD J WENZEL
Submit payment with applIcation. rallure to pay within 30' day~ will result in
fees being doubled or $100.00 plus the normal permit feat which ever is greater.
OR
Check here if you want this processed. throu.g1l, your accou.'1t [8J
#100-0750-2515-00000