HomeMy WebLinkAbout0092700-Electric
A
G
OSHKOSH
ON THE WATER
Job Address 2645 HAMILTON ST
CITY OF OSHKOSH
No 92700
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
CREATIVE CUSTOM HOMES
Create Date 01/29/2002
Contractor
MIKE DELSART ELECTRIC INC
Category 611 - Residential-New Single Family Wirin Plan
Service
p New
o Change
o Temp
Circuits
Type 0 Overhead
15
38
o Underground
Volts 110/220
Fixtures
14
Receptacles
60
Amps 200
Switches
Appliances Range, Garbage disposal, Dryer, Dishwasher, Furnace & AlC.
Use/Nature of NSFRI Wiring new home.
Work
Fees: Valuation
$3,700.00
Plan Approval
$0.00
Permit Fee Paid
$90.00
Issued By: 'K \'VI
Date 02/18/2002
D Permit Voided I
In the performance of this work I agree to perform all work pursuant to rules goveming the described construction.
Signature
Date
AgenUOwner
Address
2886 OAK STREAM DR
DE PERE
WI 54115 - 0
Telephone Number 920-336-1615
~
OJI-KOJR
ON THE WATER
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
Phone (920) 236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
JOB ADDRESS L () r ~ I 2 b v)' )/czn,..,' J +0 ^'
OWNER 5fc c.... ,
CONTRACTOR Crt. <'.. t~ v <- Cv I tOM ~, "'"->
DATE '21 {y ( 6 t
CIRCLE ALL APPLICABLE
USE CATEGORY ~INGLE FAM~
(1;)
DUPLEX
MULTI-FAMILY
RENTAL
COMMERCIAL
INDUSTRIAL
TYPE
OVERHEAD
CHANGE
Cm.tI)ERGRO~
1 'if
SWITCHES
TEMPORARY
NOT APPLICABLE
SERVICE
NO. OF FIXTURES
AMPS 20 0
1'-(
NOT APPLICABLE
RECEPTACLES 6 0
CIRCUITS
15
/ fzl1.
PHASE
S".^ t G.
VOLTS !I ~
CHECK ALL APPLICABLE
RANGEL
DISHWASHER 'f-'
WATER HEATER
GARBAGE
DISPOSAL (C
FURNACE ~
DRYER '(C
AI C 'y:
FAN OR BLOWER
ELECTRIC SIGN
MOTORS
GAS PUMPS
OTHER
DESCRIPTION OF ALL WORK BEING DONE
W ; f'L
Nlw
H;;:.',J) e l
. Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
VALUE
(Including labor,;11 alir\.. t
ELECTRICIAN ~~ ~
r;J 7a d u-I1
fixtures) $ .) ..
MASTER