HomeMy WebLinkAbout0090778-Electric (interior remodel) C.) CITY OF OSHKOSH No90778
OSHKOSH ELECTRIC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 2013 WINCHESTER AVE Owner JOHN A MYERS WF Create Date 10/24/2001
Contractor ENCOMPASS ELECTRICAL TECHNOLO Category 612 Residential Single Family Addition /R Plan
Service p New 0 Change 0 Temp Type 0 Overhead 0 Underground
Volts Circuits Fixtures 2
Amps Switches Receptacles
Appliances
Use /Nature of SFR/ Install fixture by back door, replace outlet by front door with GFCI install 2 lamp flood fixtures on the wall.
Work
Fees: Valuation $210.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: km Date 10/24/2001
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 2662 AMERICAN DR PO BOX 627 APPLETON WI 54912 627 Telephone Number (920) 225 -6507
9/ff 3iii
e) Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903 -1130
Fax (920) 236 -5084
ON HE WATER
Phone (920) 236 -5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE /6/Z2-(0/
JOB ADDRESS ?D13 )rV1CG.fS#& 4-"r
OWNER Y 61f (4t ti My-0
CONTRACTOR 614 CDVyieQ S 5 OCL' f vi Ca teni d jacti rs
CIRCLE ALL APPLICABLE
USE CATEGORY INGLE FAMI DUPLEX MULTI- FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE NEW CHANGE TEMPORARY NOT APPLICABLj)
TYPE OVERHEAD UNDERGROUND NOT APPLICABLE
NO. OF FIXTURES g SWITCHES RECEPTACLES CIRCUITS
AMPS VOLTS 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 111 f ,aX -ham a r c -4 6 W V Ktrie,e,�
0 ct4 -It-i- b y vt-f Give id/ F C 1 -I- i vl S-kc U /0, -fi>,s 4)(4 i-t 00
wA[I•
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 labor and all materials including light fixtures) 0 20.06
MASTER ELECTRICIAN
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