HomeMy WebLinkAbout0100261-ElectricOSHKOSH
ON THE WATER
Job Address 4590 SHAMBEAU DR
Contractor HOMEOWNER
Service ~) New
Volts 110/220
Amps 200
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
Owner JASON BORGARDT
Category 61t - Residential-New Single Family Wirin
Change (~ Temp I Type
Circuits
Switches
Overhead
No 100261
Create Date 03/18/2003
Plan
(~) Underground
0 Fixtures 0
0 Receptacles 0
Appliances /es
Use/Nature of qSFR/ Single family
Work
Fees: Valuation
Issued By:
$3,750.00
Plan Approval
$0.00 Permit Fee Paid $90.00
Date 3/18/03
The undersigned, in applying for an Electric Permit to perform electrical work within a single family home, owned and occupied
as the principle residence by the undersigned, hereby acknowledges per City Municipal Code Section 11-22, that other
individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the
City of Oshkosh to perform said work.
In the performance of th~ ~ork I agree to~ed~m all work pursuant t~rCes
,,,na,ure
F . t~gent/Owner
Address Oshkosh
governing the described construction.
WI 5490- 0000 Telephone Number 235-9228