HomeMy WebLinkAbout0090682-Electric CITY OF OSHKOSH No90682
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2388 SHORE PRESERVE DR Owner OSHKOSH AREA SCHOOL DISTRICT Create Date 09/11/2001
Contractor VAN ERT ELECTRIC Category 611 - Residential -New Single Family Wirin Plan
Service 140 New 0 Change 0 Temp Type 0 Overhead • Underground
Volts Circuits
Fixtures
Amps Switches Receptacles
Appliances Range, Water Heater, Garbage Disposal, Dryer, Dishwasher, Fan /Blower, Furance and A/C.
Use /Nature of NSFR
Work
Fees: Valuation $8,000.00 Plan Approval $0.00 Permit Fee Paid $150.00
Issued By: Km Date 10/19/2001
❑ 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 2000 PROGRESS WAY KAUKUANA WI 54130 - 0 Telephone Number (920) 766 -3888
e];
Division of Inspection Services
215 Church Avenue
P.O. Sox 1130
cagm Oshkosh, WI 5490-1130
ON THE WATER F ax (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 /
JOB ADDRESS CA N e ? Shore .�,Rcl,
OWNER ( ,2 �h �' - h PQ Q ` cr _ia C.-
CONTRACTOR A -
CIRCLE ALL APPLICABLE
USE CATEGORY SI NGLE FA I DUPLEX MULTI- FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE dinlill CHANGE TEMPORARY NOT APPLICABLE
TYPE OVERHEAD D ERGRO NOT APPLICABLE
NO. OF FIXTURES AA SWITCHES / t/, , 9 RECEPTACLES //f} CIRCUITS N,4
AMPS cf.nQ VOLTS.2a/ c" PHASE l ?W
CHECK ALL APPLICABLE
RANGE WATER HEATER L GARBAGE DISPOSAL L/ DRYER L -----
DISHWASHER 1/ FAN OR BLOWER L• FURNACE L A/C L '
ELECTRIC SIGN MOTORS GAS PUMPS OTHER
DESCRIPTION OF ALL WORK BEING DONE
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- - 7 - n r 4C)Ui
• 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.
1 5-0 ° ° cM,e Q
VALUE (Including labor and all materials including light fixtures) $ 2n#04)
MASTER ELECTRICIAN 1 j e ,, (')U( , Q 1 —
308 4 n P3 5V