HomeMy WebLinkAbout2002-ElectricCITY OF OSHKOSH Nos2ss7
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1522 MAPLE AVE Owner CARROLL L FAUST Create Date 02/22/2002
Contractor ENCOMPASS ELECTRICAL TECHNOLO Category 612 -Residential-Single Family Addition/R Plan
Service New ~ Change Q Temp Type ~ Overhead ~ Underground
Volts Circuits 0 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Appliances
Use/Nature of
Work
Fees: Valuation $450.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: ~y~/~ Date 03/04/2002
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
AgenUOwner
Address 2662 AMERICAN DR / PO BOX 627 APPLETON WI 54912 - 627
Telephone Number (920) 225-6507
24 O1 11:04a Code Enforcement 920-236-5084
p. 1
Division of Inspection Services.
215 Church Avenue
P.O. Box 1130
Oshkosh. WI 54903-1130
Fax (920) 236-5084
Phasic (920) 236-5046
ELECTRICAL PERMIT APPLICATION `-
AlI information after bold categories must be provided.
Incomplete applications will not be processed.
DATE a~~ g~h ~
JOB ADDRESS ~~+ 5 ~/~r~ ~~ ~ ~~ 5 ~,
OWNER (,~ f-F-FeY~S ~ ~ l ~ ~v~n n ~,' a vi
Ce>~7j J7gS S ~ /tC-~~C4 ~ rC ~il</O ~o`ll tS
CIRCLg ALL APPLICABLE
USB CATEGORY SINGLE FAMILY DUPLEX MULTI-FAMILY RfiNTAL COMMERCIAL INDUSTRIAL
58RVICB NEW CHANGg TfiMPORARY
NOT APPLICABLfi
TYP$ OVERHEAD UNDERGROUND
NOT APPLICABLE
NO. OF FIXTURES SWITCHES RECBPTACLES~_
CIRCUITS
AMPS VOLTS f
PHABg
CSECIC ALL APPLICABLE
RANGE WATER HEATER G'AR$AiGE DISPOSAL
DRYBR
DISHWASHER FAN OR BLOWER
FURNACfi A/C
ELECTRIC SIGN MOTORS
GAS PUMPS OTHER
DESCRIPTION OF ALL WORK B$INQ DONE f ~ i -~L ~7 ~ L ~ Y~ lryj o q(e
• Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, whichever is
greater.
VALUE (Incluctf.ng labor sad all materials inciudi '
ng light fixtures) $ L~J~ • D~
MASTSIt SL$CTRICIAN G~c'~~l ~ ' ~~Gy _ _ 1 y' f~~/"~N'! i ~ ~~ ~ -j o?!~ • 0 C~