HomeMy WebLinkAbout0095115-Electric (service change) C
CITY OF OSHKOSH No 95115
OSHKOSH ELECTRIC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 1809 WILSON AVE Owner JEREMY M /HEIDI HURST Create Date 06/14/2002
Contractor VAN ERT ELECTRIC Category 634 Residential- Service Change Plan
Service Q New Change 0 Temp Type Q Overhead 0 Underground
Volts 120/240 Circuits 0 Fixtures 0
Amps 100 Switches 0 Receptacles 0
Appliances
Use /Nature of SFR/ Service change. *Job #F1290AP
Work
Fees: Valuation $900.00 Plan Approval $0.00 Permit Fee Paid $40.00
Issued By: m Date 06/14/2002
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 2000 PROGRESS WAY KAUKUANA WI 54130 0 Telephone Number 920 766 -3888
08/12/02 14:15 FAX 920 788 0883 VAN ERT ELECTRIC Z002/002
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh WI 54903 -1130
Phone (920) 236-5050 �p�
Fax (920) 236 -5084 t KC )JH
ON THE WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903 -1128. Conunencing work without permit(s) will result in fees being doubled or 5100.00 plus tl
normal permit fee, which ever is greater.
OR
f ou re a contractor participari the PerrnitFee Account System and l adeouate funds, cheek be
if Yo. w rh processed thugh y
ro our account 'Pl
DATE 6 Z' O
JOB ADDRESS l; d On
OWNER N 1€ d .-1u f S
CONTRACTOR
CHECK Eli ALL APPLICABLE
USE CATEGORY
,Single Family ODuplex DMulti- Famil DRental DCommercial °Industrial
SERVICE DNew OTenipoiary TYPE gOverhead ONot Applicable
Change ONot Applicable Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts aO Receptacles Circuits
Phase in C
Amps Switches P s:tures
CHECK BI ALL APPLICABLE
ORange CjDishwasher DOarbage Disposal ODryer OWater Heater
OFan OR Blower OFurnace OElectric Sign
DMotors DGas Pumps CI Other
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) S 00
MASTER ELECTRICIAN r'1'1 U a
F e r m.. e .4e) v
Job Fiat 4P 3/i
Electric Permit Work Card
Job Address 1809 WILSON AVE Permit Number 95115 Create Date 06/14/2002
Owner JEREMY M/HEIDI HURST Contractor VAN ERT ELECTRIC
Category 634 Residential -Service Change
Service 0 New Change 0 Temp 0 N/A Type Overhead 0 Underground 0 N/A
Volts 120/240 Circuits 0 Fixtures 0
Amps 100 Switches 0 Receptacles 0
Fee $40.00 Value $900.00
Appliances
Use/Nature SFR/ Service change. *Job #F1290AP
of Work
Inspections:
Date Type Service Inspector Jon Fischer approved
6/14/02 approved
6/14/02 called in
6/17/02 mailed in
DateTme requested: 06/14/2002 07:52 AM Notice Type: Phone Number:
Access:
Ready Date/Time: 06/14/2002 07:52 AM Requested by:
0 Reinspect Fee 0 Fee Wavied Reinspect Fee Paid