HomeMy WebLinkAbout094324 -Electric (AC) CITY OF OSHKOSH No94324
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1615 MOUNT VERNON ST Owner ARVID M CARRICK Create Date 05/14/2002
Contractor MANTHEY ELECTRIC INC Category 612-Residential-Single Family Addition/R Plan
Service p New O Change O Temp Type O Overhead O Underground
Volts Circuits 0 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Appliances • C
Use/Nature of SFR/WIRING FOR A/C.
Work
Fees: Valuation $155.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: 1 Date 05/14/2002
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 83 BRYN MAWR CIR FOND DU LAC WI 54935 -0 Telephone Number 920-922-9618
0 Division of Inspection Services
215 Church Avenue
P.O. Box 1130
OfFI\OJH Fax 54903-1130
(920) 236-5084
ON THE WATER Phone (920) 236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed. I
DATE __ L )
JOB ADDRESS 14D i s Pi I V 'J" a) 0
OWNER B .. o CR .6-1 ic, H
CONTRACTORIM A 11-4( L E C 1 vS I Q I %v
CIRCLE ALL APPLICABLE
USE CATEGORY (SINGLE FAMILY) DUPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE NEW CHANGE TEMPORARY (NOT APPLICAB
TYPE OVERHEAD UNDERGROUND NOT APPLIC�PBLE
NO. OF FIXTURES SWITCHES RECEPTACLES CIRCUITS
AMPS VOLTS / PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL DRYER
DISH✓dASHER FAN OR BLOWER FURNACE A/C X
ELECTRIC SIGN MOTORS GAS PUMPS OTHER
DESCRIPTION OF ALL WORK BEING DONE
• 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.
Y
VALUE (Including labor and all materials including light fixtures) $ I J — \.i
\
MASTER ELECTRICIAN C, ' \