HomeMy WebLinkAbout0103510 EOSHKOSH
ON THE WATER
Job Address 558 MONROE ST
Contractor TK ELECTRIC
Service [~ New ~ Change ~ Temp
Volts
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner JACOB P MANGEN
Category 612 - Residential-Single Family Addition/Ret
Type I~ Overhead
Circuits 0
Switches 0
No 103510
Create Date 08/13/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of DUPLEX/New A/C and furnace.
Work
Fees: Valuation
Issued By:
$450.00 Plan Approval $0.00 Permit Fee Paid $20.00
Date 08/13/2003
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.
Signature Date
Agent/Owner
Address 2630 HILLWOOD CT APPLETON WI 54911 - 2229 Telephone Number
920-734-3104
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.
City of Oshkosh
Division of Inspection Services
P.O. Bgx 1130
~Oshkush, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O_fHKO./H
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account []
JOBABm ss
OWNER
CONTRACTOR
CHECK [] ALL APPLICABLE
USE CATEGORY
F1Single Family ~plex
[3Multi-Family
SERVICE F1New [3Temporary
[3Change UINot Applicable
[3Rental F1Commercial [3Industrial
TYPE F1Overhead [3Not Applicable
DUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
F1Range F1Dishwasher [3Garbage Disposal
UIFan OR Blower [3Furnace [3A/C
[3Motors l"lGas Pumps [3Other
DESCRIPTION OF ALL WORK BEING DONE /~/~"~L'/
DDryer ElWater Heater
FIElectric Sign
VALUE (Including labor and all materials includiqg light fixtures) $
MASTER ELECTRICIAN 7'~0 t~ ~
3/02