HomeMy WebLinkAbout0103815-Electric (interior)OSHKOSH
ON THE WATER
,Job Address 102 W 17TH AVE
Contractor ACE ELECTRIC
Service ~) New
Volts 120 / 240
Amps 100
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Change (~ Temp
Owner
Category
JOSEPH W ROZEK
612 - Residential-Single Family Addition/R
Type ~-~ Overhead
Circuits 0
Switches 0
No 103815
Create Date 08/29/2003
Plan
~'~. ~?ound
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Remodel and update lower level, includes receptacles, switches, circuits, fixtures.
Work
Fees: Valuation
Issued By: l/tz,-,'~
$950.00 Plan Approval $0.00 Permit Fee Paid $45.00
[] Permit Voided!
Date 08/29/2003
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~asement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any~p/J~vals before stanting such activity. (~¢/~ ¢/~
Signature , . ~ Date
~" ~ Agent/Owner '
Address 668 N MAIN ST OSHKOSH WI 54901 . 4443 Telephone Number 231-3644
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. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/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 ~eat~.
OR
If you are a contractor participating in the Permit Fee Account SFstem and have adequate funds, check here
if you want this processed through Four account []
Jo.~D~ss l~ z w, ~'7/-A. x'7~
OW~R ~ro~ £o~ ~
CO~OR ./~. C~7%~~
DATE
CtlECK [] ALL APPLICABLE
USE CATEGORY
~[~!lingle Family [2Duplex
[2Multi-Family
SERVICE F1New
F1Change
F1Temporary
FINot Applicable
[21Rental V1Commercial [2Industrial
TYPE FlOverhead ~qot
Applicable
F1Underground
t
FILL IN ~ APPROPRIATE BLANK WITH THE NUMBER
Volts / ~9 / ~ ,9"0 Receptacles
Phase r/
Amps t/O O Switches #
CttECK I~ ALL APPLICABLE
F1Range U1Dishwasher ElGarbage Disposal
F1Fan OR Blower I-1Fumace I-IA/C
[2Motors [2Gas Pumps (l~Other
DES,~RIPTION OF AL/L WORKtBEING DONE
/~c~ ~
Fixtures
F1Dryer E]Water Heater
F1E~[ecUic Sign
VALUE (Including labor and all m~ght fixtures) $
MASTER ELECTRICIAN
3/02