HomeMy WebLinkAbout0122764-Electric
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OSHKOSH
ON THE WATER
Job Address 1236 ELMWOOD AVE
CITY OF OSHKOSH
No
122764
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
BRIAN A PIZON
Create Date 12/01/2006
Contractor
GROVER ELECTRIC
Category 612 - Residential-Single Family Addition/R Plan
o Change 0 Temp
. N/A
Type 0 Overhead
o Underground
Service
b New
120/240
Circuits
Luminaires
Volts
Amps
100
Switches
Receptacles
Appliances
Use/Nature of SFRlRemodel bathroom in basement
Work
$385.00
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Plan Approval
$0.00
Permit Fee Paid
Fees: Valuation
$25.00
Issued By:
Date 12/01/2006
D Permit Voided I
Parcelld # 1205810000
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 t~P..~J~ application within an easement, the City strongly urges the permit applicant to contact the easement
hOlder(S~to sl(cure~y ~::~~~~provals e starting such activity. . ~,
Signature -===.1= -- Date I 2- 1- Q {.
--- Agent/Owner
Address
1650 S OAKWOOD RD
OSHKOSH
WI 54904 - 0
Telephone Number 920-379-7259
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 ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone'(920) 236-5050
Fax (920) 236-5084
~
OJHKOfH
ON THF WATER
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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 pennit(s) will result in fees being doubled or $100.00 plus the
normal pennit fee, which ever is greater.
OR
Ifvou are a contractor DarticiDatine- in the Permit Fee AccountSvstem and have adequate funds. check here
ifvou want this Drocessed throue-h your account D
DATE 'j Z - I - 0 b
,
JOB ADDRESS / L 3 @. E /.""-1 I.A/ 00 J
OWNER. '.. fJ~
CONTRACTORGvou~..V i~ !<cfirlL
CHECK fa ALL APPUCABLE
USE CATEGORY
r BSingle Family
. SERVICE DNew
DChange
DDuplex
DMulti-Family
DRental
o Commercial
OIndustrial
DTemporary
9Not Applicable
TYPE DOverhead
DUnderground
DNot Applicable
FilL IN THE APPROPRIATE BLANK WITH THE NUMBER
. Volts /2-1) f CC_(( )
:phase' S ,'1'\:7 ((
Amps i 00
Receptacles #
Circuits #
Switches #
FixtLtres #
CHECK m ALL APPLICABLE
ORange
OFan OR Blower
DMotors
DDishwasher
o Fumace
DGas Pumps.
DGarbage Disposal
DAlC
DOther
DDryer DWater Heater
DElectric Sign
DESCRIPTION OF ALL WORK BEING DONE Be, ..,,_ Mot't-j -I-
.
}~+--e;. YCl:>'-t
le~oJd(
rv ALUE (Including labor and aU~~J~rials" ding light lIxtures) $ .::5 g- S~
MASTER ELECTRI
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