HomeMy WebLinkAbout0084913-Electric CITY OF OSHKOSH No84913
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 416 ROCK PL Owner GAY L MANDEIK Create Date 03/14/2001
Contractor ACTION ELECTRIC Category 612 - Residential - Single Family Addition /R Plan
Service 0 New 0 Change 0 Temp Type 0 Overhead 0 Underground
Volts Circuits
Fixtures
Amps Switches Receptacles
Appliances
Use /Nature of SFR / INTERIOR REMODEL 1ST, 2ND FLOOR BEDROOMS & LIVING ROOM
Work
Fees: Valuation $1,400.00 Plan Approval $0.00 Permit Fee Paid $60.00
Issued By: 515 Date 03/27/2001
El 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 W1906 COUNTY ROAD JJ KAUKAUNA WI 54130 - 9417 Telephone Number (920) 788 -4020 M 585-40
Mar 14 01 09:43a Code Enconcement 920 p 1
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P.O. Bo 1130
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ELECTRICAL PERMIT APPLICATION
A11 intormati.Pn after bold categories must be provided.
Incomplete applications will not be processed.
DATE
JOB
CONTRACTOR qc-i-. E 1 eci _ ___
______. _
CIRCLE ALL APPLICABLE
USE CATEGORY (._SINGLE iA7177) DUPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE NEW CHANGE TEMRORAS (OT APPLICABLE
TYPE OVERHEAD UNDERGROUND 4:22EEEtLILS2./3)
NO. OF FIXTURES _ :1:1 RECEPTACLES CIRCUITS
AMPS / PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATER. GARBAGE DISPOSAL DRYER
----
DISHWASHER FAN eR IP LOWER FURNACE - A/ C
_... . --
ELECTRIC SIGN , :CiTfCRS GAS PUMPS - - - - OTHER
DESCRIPTION OF ALL WORK BFIN DONE_ .._ " CI VI vqi g.clo4v% 1 W 1 C3v)kooA.,
Ot ___ 2 "/ 1 ___ F 0 it. x i 1 w „... ,
• Submit payment with applicai;ion. Failure to pay within 30 days will result in
tees being doubled or plus tl normal pemit tee, wnich ever is
Greater.
oo
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTR:CIAN ev4 /4