HomeMy WebLinkAbout0123258-Electric (family room)
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OSHKOSH
ON THE WATER
Job Address 542 GROVE ST
CITY OF OSHKOSH
No 123258
ELECTRIC PERMIT - APPLICATION AND RECORD
JOSEPH S GIBSON
Create Date 01/22/2007
Owner
Contractor
HOMEOWNER
Category 612 - Residential-Single Family Addition/R Plan
Service
~,
o Change
o Temp
. N/A
Type
o Overhead_
o Underground
Volts
Amps
Circuits
Luminaires
Switches
Receptacles
Appliances
Use/Nature of ~FR\ Finish off a portion of the basement for a family room. Replace existing wiring & add new to include: recessed cans & switching,
Wo<k ["'Pis' aod ba",boa" heale'" + pro~o", fo< tutu", addltioo.
Fees: Valuation
$1,200.00
Plan Approval
$0.00
Permit Fee Paid
$77.00
Issued By:
/(flc
Date 1/22/2007
o Permit Voided I
Parcelld # 1103010000
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 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 per . pplication within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to any nec,e" ~ry.a~s or arting. such activity. 7
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Signature Date _ v
Agent/Owner
Address
OSHKOSH
WI 5490 - 4608 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 projectis ready.
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City.ofOshk~sh
Division of Inspection Sexvices
P.o. Box 1130
Oshkosh, WI 54903-1130
Phone'(920) 236-5050"
Fax (920) 236-5084
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OJHKOfH
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
If vou are a contractor 'Dartici'Datine in the Permit Fee Account Svstem and have adequate funds. check here
ifvou want this 'Drocessed throuf!h vau1- account 0' .
DATE j'-dd'-V 7
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JOB ADDRESS .sf{.;? t;,:,=r-oi/tE2? C v '~
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OWNER. ( / iO 6'/!?,/) /7 J , If... ,/.05 If? ,~
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CONTRACTOR Oi/f//l/R r-"
CHECK fa ALL APPLICABLE
. ,
~E CATEGORY
............l6'Single Family . DDuplex OMulti-Family
'SERVICE, DNew OTemporary
DChange ONot Applicable
ORental
o Commercial
OIndustriaI
TYPE OOverhead
DUnderground
ONot Applicable
, FllL IN THE APPROPRIATE BLANK WITH THE NUMBER
. Volts
:phase
Amps
I
Receptacles #
Circuits #
Switches #
Fixtures #
CHECK m ALL APPLICABLE
ORange
OPan OR Blower
OMotors
OGarbage Disposal
DAlC
OOther
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ODryer DWater Heater
OElectric Sign
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, VALUE (Including labor and all ma~ls including Ii ht f'lXtures) $ (./ C/ ,
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