HomeMy WebLinkAbout0113050-Electric (service change) t
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OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECOR
ON THE WATER �q7�E
Job Address 802 IDAHO ST Owner SECRETARY OF HOUSING AND URBAN Create Date 03/16/2005
Contractor HOMEOWNER Category 634-Residential-Service Change Plan `
Service New � Change � Temp � N/A Type � Ovefiead � Underground I
Volts 120/240 Circuits 0 Fixtures 0
Amps 100 Switches 0 Receptacles 0
Appliances
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Use/Nature of FR/ Service chage-issued to new owner Gwen Heagle,who recently purchased property and is the occupant. All work is required to ;
Work mply with COMM 16. Any additional Value of work will require additional peRnits
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Fees: Valuation $250.00 Plan Approval $0.00 Permit Fee Paid $20.00 �
Issued By: Date 3/16/05 '
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� Permit Voided � Parcel Id#0601490100 ;
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The undersigned,in applying for an Electric Permit to perform electrical work within a single family home,owned and occupied
as the principle residence by the undersigned,hereby acknowledges per City Municipal Code Section 11-22,that other :
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individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the ;
City of Oshkosh to perform said work.
In the performance of this work I agree to perform all work pursuant to rules goveming 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 perrnit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to ecur a neces ry ap Is befor tarting such activity.
Si natur Date �
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genUOwner 4
Address SECRETARY OF HOUSING AND URBA� MINNEAPOLIS MN 5540- 0000 Telephone Number �
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To schedule inspections please call the Inspection Request line at 236-5128 noting the Address,Permit Number,Type of F
Inspection(i.e. Footing,Service, Final,etc.),Access into Buiiding if Secure(how do we gai�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. �;
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City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VVI54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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ON THF WATER
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
[(YOU are a contractor particivating in the Permit Fee AccountSystem and have adeQuate funds. check here
if YOU want this processed throuf!h your account 0
DATE ~-;4~c2tJcf~
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CONTRACTOR
US CATEGORY
ingle Family
OMulti-Family
o Rental
~Commercial Ofudustrial
~verhead DNot Applicable
DUnderground
DTemporary
DNot Applicable
TYPE
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
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Receptacles #.
Circuits #
Switches #
Fixtures #
~ ItI ALL AP
. ange .
an OR Blower
OMotors Gas Pumps o Other
DESCRIPTION OF ALL WORKBEINGDO~~ ~--z,.~
.. VALUE (Including labor and all materials including light fIxtures) $ ~<50. crc:-J
MASTER ELECTRICIAN
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3/02