HomeMy WebLinkAbout0090055-Electric 10 CITY OF OSHKOSH No 90055
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1842 MICHIGAN ST Owner DEL TRITT Create Date 05/17/2001
Contractor D&A ELECTRIC Category 611 - Residential -New Single Family Wirin Plan
Service 0 New 0 Change 0 Temp Type 0 Overhead • Underground
Volts 120/240 Circuits Fixtures
Amps 100 Switches Receptacles
Appliances RANGE, DW, DISP, DRYER, FURN. AC
Use /Nature of NSFR
Work
Fees: Valuation $3,600.00 Plan Approval $0.00 Permit Fee Paid $90.00
Issued By: Date 10/04/2001
❑ Permit Voided
In the perfo ce of this work I agree to perfo II work pursuant to rules goveming the described construction. ' J
Signature M.� pin • I Date - "t'0,
Agent/Owner
Address P 0 BOX 258 DALE WI 54931 - 258 Telephone Number (920) 851 -5920
I
(;;111;) Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903 -1130
oN Hewn a 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 S " /7 0/
JOB ADDRESS i � 9 ?
OWNER
CONTRACTOR D I ALIT
CIRCLE ALL APPLICABLE
USE CATEGOR SINGLE FAMIL DUPLEX MULTI- FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE CHANGE TEMPORARY NOT APPLICABLE
TYPE OVERHEAD ERGROUND/ NOT APPLICABLE
NO. OF FIXTURES 3 $ SWITCHES RECEPTACLES ,V5 CIRCUITS l3
AMPS / O U VOLTS/ / PHASE
CHECK ALL APPLICABLE
RANGE K WATER HEATER GARBAGE DISPOSAL X DRYER
DISHWASHER FAN OR BLOWER FURNACE K A/C/
SIGN MOTORS GAS PUMPS OTHER
DESCRIPTION OF ALL WORK BEING DONE 1 i Qr-
• 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 90 PlivnkAA
VALUE (Including labor and all materials including light fixtures) $ 3 Ip 00, 0 0
MASTER ELECTRICIAN aLf)/k/ykA0 Art
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