HomeMy WebLinkAbout0099707-ElectricOSHKOSH
ON THE WATER
JobAddress 3210 BELLFIELD DR Owner
Contractor VAN ERT ELECTRIC Category
Service ~ New (~) Change (~ Temp I
Volts 120/240 Circuits
Amps 200 Switches
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
CREATIVE CUSTOM HOMES & DEVELOP
611 - Residential-New Single Family Wirin
Type (~ Overhead
18
30
No 99707
Create Date 02/03/2003
Plan
(~) Underground
Fixtures
Receptacles
60
Appliances Range, Dishwasher, Garbage Disposal, Dryer, Fan or Blower & Furnace.
Use/Nature of NSFPJ Wire new home. *JOb #F1512-CT.
Work
Fees: ValUation
Issued By:
$4,500.00 Plan Approval $0.00 Permit Fee Paid $105.00
Date 02/06/2003
[] 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
02/06/02 09:53 FAX 920 766 0883 VAN ERT ELECTRIC ~009/009
Cji), of Oshkosh
-Division of Iml~'ction Se~ices
P.O. Box 1130
Oshkosh, Wi 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
Ali information after bold categorie~ must be provided.
[ncomplelc applications will not be processed.
HKO/H
ON T~II~
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box ! [28.
Oshkosh WI 54903-1128. Commenc/ng work Without permit(s) will result in fees b~ing doubled or $100.00
normal permit fee, which ever is greater.
OR
check
· o want i~ roce sedthr- ~
CHIICK [~ ALL APPLICABLE
~S~ CATEGORY
z,l~a~ngle Family r'lDuplex l-lMulti-Family DRental
SERVICE_~ew ClTemporary TYPE
ElChange ClNot Applicable
FILL IN ~ APPROPRIATE BLANK WITH TI~ ,NUMI~.ER
Volt~ - 1'20 t. 240 Receptacles # ~O
Phase ~ ' - '
Amps ~'~'~' Switches # '~)
I-ICommercial Uilndustria[
ElOvcrh~d ~Not Applicable
~"ndergro und
Circuits #
Fixtures
CHECK ~ ALL APPLICABLE
Rangc '~ishwasher
an OR Blowc~ ,~tn~ace
ElMotors ElGas Pumps
DESCRIPTION OF ALL WORK BRING DONE
...~arbage Disposal ~I~yer
OMC OElee~c Sign
E3Other
DWater Heater
VALUE (Including I,abor an~l all materials including light fi~tures) $ ~4! ~) ,~
~S~R EL~C~