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OSHKOSH
ON THE WATER
Job Address 1044 MOUNT VERNON ST
CITY OF OSHKOSH
No
122794
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
MARY E SWAW
Create Date 12/04/2006
Contractor
TOWN & COUNTRY ELECTRIC
Category 634 - Residential-Service Change
. Change 0 Temp
ON/A
Type . Overhead
Plan
o Underground
Service
b New
120/240
Circuits
Luminaires
Volts
Receptacles
Amps
100
Switches
Appliances
Use/Nature of SFR\ 100 amp Service change.
Work
Fees: Valuation $500.00
Issued By: ~k)
Plan Approval
$0.00
Permit Fee Paid
$25.00
Date 12/05/2006
D Permit Voided I
Parcel Id # 1003400000
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 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
PO BOX 627
APPLETON WI 54912 - 627
Telephone Number 920-225-6507
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address" Permit Number, Type of
Inspection (Le. 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.
Faith Technologies->
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City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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ELECTRICAL PERMIT APPLICATION
All infonnation after bold categories must be provided.
Incomplete applications will not be processed.
Page BB2
J6fo# 376551
· 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
nonnal permit fee, which ever is greater.
OR
I ou are a contractor artici atin in th' erm~'t check here
if you want this processed throullh vour account
:QATE
/;) -tf-o ~
.JOB ADDRESS II) L/ '-I M ()u Vl1- V t (I' YltJ h Sf.
OWNER S W A-1A)
CONTRACTOR '/t;UJM c.r UU-t1 Ivy &Itt-hit..
/,"" CHECK Ii2J ALL APPLICABLE
~,
.~. '
~.! I
USE CATEGORY
DSingle Family DDuplex
DRental
.tJCommercial
DMulti-Family
SERVICE DNew
t;aChange
TYPE p;10verhead
DUnderground
DTemporary
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts
Phase
Amps
I
Rec~ptacles #
Circuits #
Switches #
Fixtures #
CHECK ~ ALL APPLICABLE
ORange
OFan OR Blower
DMotors
DDishwasher
DFurnace
DGas Pumps
DGarbage Disposal
DAlC
o Other
DDryer DWater Heater
, OElectric Sign
Olndustrial
DNot Applicable
DESCRIPTION OF ALL WQRK BEING DONE
ehtJ I/ltt;
S ( V1)1l- (. .
tJu-!-s)d..t t1Y1/v -/1;v /00 A-UP
,
VALUE (Including labor and all materials including light fIXtures) $ 500 . tJ 0 Fr'C: jf :J-5. () 0
MASTER.ELECTRICIAN '~d 4~ 'St..tt.("'~(...e" cr. J.M
3102