HomeMy WebLinkAbout2006-Electric
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OSHKOSH
ON THE WATER
Job Address 4014 PRAIRIE LN
CITY OF OSHKOSH
No
123005
ELECTRIC PERMIT - APPLICATION AND RECORD
o Change 0 Temp
Owner DAVID A1KATHLEEN E GODING Create Date 11/17/2006
Category 612 - Residential-Single Family Addition/R Plan
. N/A Type o Overhead o Underground
Circuits 1 Luminaires
Switches Receptacles 6
Contractor
TEAM SERVICES INC
Service
b New
Volts
Amps
Appliances
Use/Nature of SFR/ WIRE SUNROOM TSI JOB #72137
Work
Fees: Valuation
$200.00
Plan Approval
$0.00
Permit Fee Paid
$25.00
Issued By: ~LA)
Date 12/27/2006
D Permit Voided I
Parcelld # 1528660000
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 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
2602 AMERICAN DR
APPLETON WI 54914 - 9010
Telephone Number 920-738-5885
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
1~t Jtbt= <131 13"7
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DEe 2 7 2006
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OfHKOfH
ON THE WATER
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. 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
If you are a contractor varticipating in the Permit Fee Account System and have adequate funds. check here
if yOU want this processed through your account 0 .
DATEJa!;no {(O(P
CHECK ItJ ALL APPLICABLE
US~ CATEGORY
~ingle Family DDuplex
DMulti-Family
o Rental
o Commercial
DIndustrial
(\
SERVICE DNew
DChange
DTemporary
DNot Applicable
I
TYPE DOverhead
DUnderground
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts
Phase
Amps
/
Receptacles # &,
Switches # \
Circuits # _I
Fixtures # _I
CHECK ItJ ALL APPLICABLE
ORange
DFan OR Blower
DMotors
DDishwasher
DFumace
DGas Pumps
DGarbage Disposal
DAlC
DOther
o Dryer OWater Heater
OElectric Sign
DESCRIPTION OF ALL WORK BEING DONE ~ \ re s\ \/1 'fCr'('{)
VALUE (Including labor and all materials including light fixtures) $ 2100. ro / "$ 31';). CD
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