HomeMy WebLinkAbout2004-ElectricCITY OF OSHKOSH
105937
No
OSHKOSHELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job AddressOwnerCreate Date12/08/2003
3855 WOOD DUCK CTANDREW HOMES INC
ContractorZWIERS ELECTRICCategory611 - Residential-New Single Family WiringPlan
ServiceTypeOverheadUnderground
NewChangeTemp
Volts120 / 240Circuits0Fixtures0
Amps200Switches0Receptacles0
Range, Dishwasher, Fan or Blower, Garbage Disposal, Dryer, Furnace, A/C
Appliances
Use/Nature of NSFR/ 2 story home with a 3 car attached garage, rear screened porch.
Work
Plan Approval$0.00
Fees: Valuation$12,000.00Permit Fee Paid$204.00
Issued By:Date01/05/2004
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
SignatureDate
Agent/Owner
N4189 MURPHY RDKAUKAUNAWI541300920-788-2533
Address-Telephone Number
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
- � �a�y� o0
O Division of Inspection Services � , ..
� 215 Church Avenue
P.O. Box 1130 �-^e8��
n���V� ��� � Oshkosh, WI 54 9 03-113 0 � ���
LJoN YE\_JJ I� Fax (920) 236-5089 �� .y�
Phone (920) 236-5046
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ELECTRICAL PERMIT APPLICATION . ; ��
All information after bold categories must be provided�. -� y;?�t1f�r,y�i,
Zncomplete applications will not be processed.
DATB �a-.�o-o �
JOB ADDRESS ,�jC�J� C�J` CX�` D ��.ICI� �T.
owrrER /'�l�] �(��.i.l? C7�6�►2�5
CONTRACTOR__�(�'}�'�,S �C GT IZ� C
CIRCLE ALL APPLICABLE_,
USS CATSGORY NGLE FAMILY UPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE NEu� CHANGE TEMPORARY NOT APPLICABLE
TYPE OVERHEAD DERGROUN NOT APPLICABLE
N0. OF FIXTURES SWITCHES RECEPTACLES CIRCUITS
AMPS� VOLTS iaa � p� � PHASE
CHECK ALL APPLICABLS
RANGE � WATER HEATER GARBAGE DISPOSAL �/ DRYER �/
DISHWASHER � FAN OR BLOWER � FURNACE ✓ A/C 1�
ELECTRIC SIGN_ MOTORS_ GAS PUMPS_ OTHER
DHSCRIPTION OF ALL WORK BBING DONE
l.vJ, RG $ l7
• 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.
VALUB (Including labor and all materials including light fixtures) $ � O���C� � C��
MAST&R ELHCTRICIAN �