HomeMy WebLinkAbout0097049-Electric
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OSHKOSH
ON THE WATER
Job Address 2772 HAMILTON ST
Contractor MIKE DELSART ELECTRIC INC
CITY OF OSHKOSH
No 97049
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner THOMAS N RUSCH Create Date 07/17/2002
Category 611 - Residential-New Single Family Wirin Plan
Service
18 New
o Change
o Temp
Volts 120/240
Circuits
Type 0 Overhead
15
o Underground
Fixtures
16
Amps 200
Switches
o
Receptacles
o
Appliances Range, Dishwasher, Garbage Disposal, Furnace, Dryer & AlC.
Use/Nature of NSFR/ New home wiring.
Work
Fees: Valuation
Issued By: k V"f"
$3,900.00
Plan Approval
$0.00
Permit Fee Paid
$90.00
Date 09/04/2002
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
2886 OAK STREAM DR
DE PERE
WI 54115 - 0
Telephone Number 920-336-1615
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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
I
All information after bold categories must be provided.
Incomplete applications will not be processed.
JOB ADDRESS ~ll').. ~~\+~ u;t. \"d.~
OWNER ~~~, ~k ~
CONTRACTOR ~~\~ G},.s..~ . ~
DATE~
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY
~
OVERHEAD
DUPLEX
MULTI-FAMILY
RENTAL
COMMERCIAL
INDUSTRIAL
FIXTURES
\le
~
SWITCHES
TEMPORARY
NOT APPLICABLE
SERVICE
TYPE
NOT APPLICABLE
NO. OF
RECEPTACLES
CIRCUITS
IS
AMPS
;;;;K.:0
VOLTS ,~ /"d-,*-O
PHASE
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CHECK ALL APPLICABLE
RANGE~ WATER HEATER
DISHWASHER~ FAN OR BLOWER
GARBAGE DIS~OSAL~
FURNACE ~
DRYER~
A/C.::iL
ELECTRIC SIGN
MOTORS
GAS PUMPS OTHER
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I
DESCRIPTION OF ALL WORK BEING DONE t~
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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 laborA"tr al~S
ELECTRICIAN ?'7l:lls- t{J
including light fixtures) $ ~9 ~ ,(7:)
MASTER