HomeMy WebLinkAbout0097051-Electric
.
OSHKOSH
ON THE WATER
Job Address 2764 HAMILTON ST
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
No 97051
Owner
CREATIVE CUSTOM HOMES
Create Date 07/17/2002
Contractor
MIKE DELSART ELECTRIC INC
Category 611 - Residential-New Single Family Wirin Plan
Service p New
Volts 120/240
Circuits
Type 0 Overhead
15
o Underground
o Change
o Temp
Fixtures
16
o
Amps
200
Switches
o
Receptacles
Appliances Range, Dishwasher, Garbage Disposal, Furnace, Dryer & AlC.
Use/Nature of NSFRI New home wiring.
Work
Fees: Valuation
Issued By: ~1fY\
$3,900.00
Plan Approval
$0.00
Permit Fee Paid
$90.00
Date 09/04/2002
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
Agent/Owner
Address 2886 OAK STREAM DR
DE PERE
WI 54115 - 0
Telephone Number 920-336-1615
_ .C".
~
OJH<OJH
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.d--\ \\n~~\-t<h ~-\- \d-~
~e.ch'~ -> c \"-~~~ ~S
CONTRACTOR ~~~ ~&4-Y\ ~
DATE ~WD~
OWNER
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY
~
OVERHEAD
DUPLEX
MULTI-FAMILY
RENTAL
COMMERCIAL
INDUSTRIAL
FIXTURES
Il.e
CHANGE
~RGRO~
SWITCHES
TEMPORARY
NOT APPLICABLE
SERVICE
TYPE
NOT APPLICABLE
NO. OF
RECEPTACLES
CIRCUITS l~
AMPS c::~
VOLTS \)..D /'d-'-\:'D
PHASE
~~
CHECK ALL APPLICABLE
ro
WATER HEATER~
FAN OR BLOWER
GARBAGE DISPOSAL~
FURNACE~
DRYE~
RANGE -.::12.
DISHWASHER~
A/C~
ELECTRIC SIGN
MOTORS
GAS PUMPS
OTHER
DESCRIPTION OF ALL WORK BEING DONE ~..r<-- ~ ~"&"\&l~-\ ~ ~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 l~::~f\'l'~S including
ELECTRICIAN '7 r tc1!:-- U tr;--
light fixtures) $~~o..} ,LG
MASTER