HomeMy WebLinkAbout0100036-Electric (fire damage)OSHKOSH
ON THE WATER
Job Address 716 MOUNT VERNON ST
Contractor QUALITY ELEC.
Service ~) New (~ Change'
Volts 120 / 240
CITY OF' OSh-KOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
Am ps 100
O Temp
No 100036
Owner KELLY J BURNETT Create Date 01t20/2003
Category 612- Residential-Single Family Addition/R Plan
I Type _~. Overhead .......... _(~_ Underground j
Circuits 0 Fixtures 6
Switches 6 Receptacles 14
Appliances
Use/Nature of ;FR/ Fire damage repair & code violation
Work
Fees: Valuation
Issued By: ~
$1,500.00
Plan Approval
$0.00 Permit Fee Paid $60.00
Date 03/03/2003
[] Permit Voided J
In the performancu~of this wo.r~agree~lo perform all work pursuant to rules governing the described construction.
Signature
/ /~ Agent/Owner
Date
Address 3754 GLENHURST LN
OSHKOSH WI 54904 - 8524 Telephone Number
(920) 233-8931
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
ON THE WATER
Phone (920) 236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
CIRCLE ALL APPLICABLE
USE CATE RY DUPLEX
SERVICE NEW
TYPE OVERHEAD
NO. OF FIXTURES
MULTI-FAMILY
CHANGE
UNDERGROUND
SWITCHES 0
VOLTS /'2~) / 2 7o
RENTAL COMMERCIAL INDUSTRIAL
TEMPORARY ~0T APPLICABLE-'~
RECEPTACLES /4 CIRCUITS ~
PHASE /
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL DRYER
DISHWASHER FAN OR BLOWER FURNACE A/C
ELECTRIC SIGN MOTORS GAS PUMPS OTHER
DESCRIPTION OF ALL WORK BEING DONE ~r'~V ~' ~"~ge ~F~,C ~ ~:o~. ~/~¥{~¢;~"~
Submit payment with application. Failure to pay within 30 days will resul~ in
fees bein~ doubled or $100.00 plus the normal permit fee, which ever is
~reater.
VALUE (Including labor and all materials including light fixtures)
MASTER ELECTRICIAN