HomeMy WebLinkAbout0122771-Electric (basement remodel)
o
OSHKOSH
ON THE WATER
Job Address 815821 W PACKER AVE
CITY OF OSHKOSH
No
122771
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
JOSEPH F ZOLKOSKE III/JUDITH A CLlF Create Date 12/01/2006
Contractor
HOMEOWNER
Category 612 - Residential-Single Family Addition/R Plan
o New
o Change
o Temp
. N/A
Type
o Overhead
o Underground
Service
Volts
Circuits
Luminaires
Amps
Switches
Receptacles
Appliances
Use/Nature of
Work
INDO\ Wire basement rooms.
$25.00
Fees' ValUati~ .~. .
Issued By:
.
/
$500.00
Plan Approval $0.00
Permit Fee Paid
Date 12/1/2006
o Permit Voided I
Parcelld # 1219742300
The undersigned, in applying for an Electric Permit to perform electrical work within a single family home, owned and occupied
as the principle residence by the undersigned, hereby acknowledges per City Municipal Code Section 11-22, that other
individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the
City of Oshkosh to perform said work.
In the performance of this work I agree to perform all work pursuant to rules governing the descr.ibed construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any neces approval e e s / ing such activity.
Signature
Date 161-- 1-6J 0
Address
OSHKOSH
~ 5490 - 0000 Telephone Number
--
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh .
Division ofInspecrion Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone'(920) 236-5050
Fax (920) 236-5084
~
OJHKOfH
ON THF WATER
r,
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be proce$sed.
. Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oslikosh WI 54903-1128. Commencing work without perm.it(s) will result in fees being doubled or $100.00 plus the
nonnal permit fee, which ever is greater.
OR
Ifvou are a contractor participating in the Permit Fee Account System and have adeQuate funds. check here
ifvou want this Drocessed throuf!h vou~ account D' .
DATE J' 7_1__/]/
0, .L' b
JOB ADDRESS g' f <) W j (;::J (/J Lttee. r'
-, i I C' I rf' A /~
OWNER . _) VI d I r h. A: !fr (;t;./ -.Jot?
CO~CTOR C) V'-" Il 2, r ----
Are..
'7 /t/ \
C.Ofi'<- C ~< I
CHECK lil ALL APPLICABLE
USE CATEGORY
r DSingle Family'~Duplex
DMulti-Family
o Rental
DCommercial
OIndustrial
. SERVICE DNew
DChange
DTemporary
DNotApplicable
TYPE DOverhead
DUnderground
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
. V ofts
:rhase
:Amps
f
Receptacles #
Circuits #
Switches #
Fixtlires #
CHECK 6!J ALL APPLICABLE
ORange
OFan OR Blower
DMotors
ODishwasher
OFurnace
DGas Pumps
DGarbage Disposal
DAlC
DOther
DDryer OWater Heater
DElectric Sign
DESCRIPTION OF ALL WORK BEING DONE Wi rt'/ , fJ5-e :;';:"'7, roo MJ'
:MASTER ELECTRICIAN
rv ALUE (Including labor and all materials including light llXture
3/02