HomeMy WebLinkAbout0097899-Electric l CITY OF OSHKOSH No 97899
OSHKOSH ELECTRIC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 494 WINDINGBROOK DR Owner JAMES MATHUSEK Create Date 09/06/2002
Contractor SCHOMMER ELECTRICAL CON Category 611 Residential -New Single Family Wirin Plan
Service 0 New 0 Change 0 Temp Type 0 Overhead 0 Underground
Volts 120/240 Circuits 0 Fixtures 0
Amps 200 Switches 0 Receptacles 0
Appliances Range, Dishwasher, Water Heater, Fan or Blower, Garbage Disposal, Furnace, Dryer NC.
Use /Nature of NSFR/ Wire new home.
Work
Fees: Valuation $7,540.00 Plan Approval $0.00 Permit Fee Paid $150.00
Issued By: 3'1■A Date 10/09/2002
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 N 164 TWO MILE ROAD APPLETON WI 54914 9121 Telephone Number (920) 731 -2299
(1.-4-1:5) Division of Inspection Services
215 Church Avenue
P.O. Sox 1130
Oshkosh, WI 54903 -1130
ON THE WATER Fax (920) 236 -5084
Phone (920) 236 -5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 10/08/02
V iE 7 12)
JOB ADDRESS 494 Windingbrook
OCT o
9 2o0
OWNER GA 1 1 Pry HnmP s
Com �pA MEN
CONTRACTOR Schommer Electrical Contracting, Tnr_ LINITy r
CIRCLE ALL APPLICABLE uGCEL OP'Y 'EN r
USE CATEGORY SINGLE FAMILY DUPLEX MULTI- FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE 4 11111 CHANGE TEMPORARY NOT APPLICABLE
TYPE OVERHEAD UNDERGROUN NOT APPLICABLE
NO. OF FIXTURES SWITCHES RECEPTACLES CIRCUITS
AMPS 200 VOLTS 120 240 PHASE single
CHECK ALL APPLICABLE
RANGE v/ WATER HEATER J GARBAGE DISPOSAL DRYER J
DISHWASHER/ FAN OR BLOWER/ FURNACE A/C
ELECTRIC SIGN MOTORS GAS PUMPS OTHER
DESCRIPTION OF ALL WORK BEING DONE new home wiring
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) $7,540.00
n Fee Amt $150.00
MASTER ELECTRICIAN
Robert A. Schommer