HomeMy WebLinkAbout0092738-Electric (misc rewire)
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OSHKOSH
ON THE WATER
Job Address 3346 HARBOR SAY RD
CITY OF OSHKOSH
No 92738
ELECTRIC PERMIT - APPLICATION AND RECORD
Service
b New
o Change
Owner MATT & JANE RICHARDSON Create Date 01/28/2002
Category 612 - Residential-Single Family Addition/R Plan
o Temp Type o Overhead o Underground
Circuits 0 Fixtures 0
Switches 0 Receptacles 0
Contractor DREXLER ELECTRIC
Volts
Amps
o
Appliances
Water Heater & Dishwasher
Use/Nature of SFRI Rewire water heater, dishwasher, outlets & switches.
Work
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Fees: Valuation
$550.00
Plan Approval
$0.00
Permit Fee Paid
$25.00
Issued By: -1L- y/\
Date 02/20/2002
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
490 COUNTY ROAD FF
Agent/Owner
PICKETT
WI 54964 - 0
Telephone Number 589-6700 - 213-0230
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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
All information after bold categories must be provided.
Incomplete applications will not be processed.
JOB ADDRESS .3 3 Y G H At't.~ofl. (5141 (2j(
OWNER rV\ VrTr f2t"c h V\ fl D 9\)0
CONTRACTOR'~ (2:1:3)< l.GYL et 1:;C.-~:'12.l c
DATE :J - f( ~- 0 ::L-..
CIRCLE ALL APPLICABLE
USE CATEGORY~~UPLEX
SERVICE NEW CHANGE
MULTI-FAMILY
RENTAL
COMMERCIAL
INDUSTRIAL
TYPE
OVERHEAD
UNDERGROUND
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TEMpORARY_.-___._.C~T-!PPLI CABLE~
C-iiQi_APPLicABii>
NO. OF FIXTURES
SWITCHES
RECEPTACLES
CIRCUITS
AMPS
VOLTS
/
PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATE~
GARBAGE DISPOSAL
DRYER
DISHWASHER~ FAN OR BLOWER
FURNACE
AjC_
ELECTRIC SIGN MOTORS
GAS PUMPS
OTHER
DESCRIPTION OF ALL WORK BEING DONE
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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 ~
ELECTRICIAN
a(;671"
-SD ~ ;J
including light fixtures) $ ~
MASTER
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