HomeMy WebLinkAbout0096813-Electric
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OSHKOSH
ON THE WATER
Job Address 2728 HAMILTON ST
CITY OF OSHKOSH
No 96813
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner CREATIVE CUSTOM HOMES Create Date 07/17/2002
Contractor MIKE DELSART ELECTRIC INC
Category 611 - Residential-New Single Family Wirin Plan
Service
b New
o Change
o Temp
Circuits
Type 0 Overhead
16
o Underground
o
Receptacles
16
o
Volts 120/240
Fixtures
Amps 200
Switches
Appliances Range, Dishwasher, Garbage Disposal, Furnace, Dryer & AlC.
Use/Nature of NSFRI Wire new home.
Work
Fees: Valuation
Issued By: ~
$3,900.00
Plan Approval
$0.00
Permit Fee Paid
$90.00
Date 08123/2002
o Permit Voided I
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Address
2886 OAK STREAM DR
Agent/Owner
DE PERE
WI 54115 - 0
Telephone Number 920-336-1615
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OJH<OJR
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.
DATE ~.&", k~H""'
OWNER
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CONTRACTOR
CIRCLE ALL APPLICABLE
USE CATEGO~Y SI~ FAMILY DUPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE ~ CHANGE TEMPORARY NOT APPLICABLE
OVERHEAD ~RGR~~ NOT APPLICABLE
NO. OF FIXTURES-.JC.l SWITCHES RECEPTACLES
AMPS dOl.? VOLTS I(}o/ d-.4D
TYPE
CIRCUITS
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PHASE <S \~ :...e .
CHECK ALL APPLICABLE
DISHWASHER D
FAN OR BLOWER
FURNACE
()
DRYER ~
AI C {J
RANGE
~
WATER HEATER
GARBAGE DISPOSAL ~
ELECTRIC SIGN MOTORS GAS PUMPS
DESCRIPTION OF ALL WORK BEING DONE \...0,\,<,(1' ~ ~e...~\d Q'F\+~O-l
OTHER
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. 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 a
ials including light fixtures) $ ~<=1 eX) :C0
MASTER ELECTRICIAN