HomeMy WebLinkAbout0105993-Electric (main breaker)CITY OF OSHKOSH
105993
No
OSHKOSHELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job AddressOwnerCreate Date01/08/2004
2307 JEFFERSON STMICHAEL R/DAWN LARSEN
ContractorSTUMPF ELECTRIC INC.Category634 - Residential-Service ChangePlan
ServiceTypeOverheadUnderground
NewChangeTemp
VoltsCircuits0Fixtures0
Amps0Switches0Receptacles0
Appliances
Use/Nature of SFR/ Main breaker replacement.
Work
Plan Approval$0.00
Fees: Valuation$180.00Permit Fee Paid$20.00
Issued By:Date01/08/2004
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
2727 E BROADWAY DRAPPLETONWI549130(920) 968-0285
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.
~._ Division of Inspection Services
215 Church Avenue
P.O. Box 1130
I 1 Oshkosh, WI 54903-1130
~j Fax (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. / ~,` ~
// DATE / [~ Lf7
JOB ADDRESS ~%' ~~ ~ ~~ ,~~i ~'
OWNER ~'~l C~~J~ ~/ G-~~~`~'~I~
CONTRACTOR ;~~i( ~j~ 1 ~/ ~~~~,% C
CIRCLE ALL APPLICABLE
USE CATEGORY E__FAM~ LYE DUPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE 1 NEW CHANGE TEMPORARY L NOT APPLICABLE
TYPE OVERHEAD UNDERGROUND NOT APPLICABLE
NO. OF FIXTURES SWITCHES RECEPTACLES
AMPS VOLTS / PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL
DISHWASHER FAN OR BLOWER FURNACE
ELECTRIC SIGN
MOTORS GAS PUMPS
CIRCUITS
DRYER
A/C
OTHER
DESCRIPTION OF ALL WORK BEING DONE ~j~.~~ ~ ~ ~ ra~~~ ~~~ts~_;.~u~,~'--
• 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.
VALUE (Including labor an,~l all materials including light fixtures) $ f ~~ ~,~~
MASTER ELECTRICIAN
Electric Permit Work Card
Job Address 2307 JEFFERSON ST Permit Number 105993 Create Date 01/08/2004
Owner MICHAEL R/DAWN LARSEN Contractor STUMPF ELECTRIC INC.
Category 634 -Residential-Service Change
Service New 0 Change (~ Temp ~ N/A Type ^ Overhead ~ Underground ~ NIA
Volts Circuits 0 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Fee $20.00 ^ Value $180.00
Appliances
Use/Nature
of Work
Main
Inspections:
Date 01/12/2004 Type Service
Phone Request
1/12/04 called in
1/19/04 mailed in
Inspector Jon Fischer ////'
Date/Time requested: 01/08/2004 04:14 PM Notice Type:
Access:
approved
Phone Number: 378-1812
Ready Date/Time: 01/12/2004 09:45 AM Requested by: STUMPF ELECTRIC INC.-Jesse
Reinspect Fee ~ Fee Wavied ^ Reinspect Fee Paid