HomeMy WebLinkAbout0123554-Electric
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OSHKOSH'
ON THE WATER
Job Address 1227 JACKSON ST
CITY OF OSHKOSH
No
123554
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
VICTOR A GIRENS JR
Create Date 02/19/2007
Contractor
HOMEOWNER
Category 612 - Residential-Single Family Addition/,l3 Plan
Service
p New
o Change
o Temp
. N/A
Type 0 Overhead
o Underground
Volts
Amps
Circuits
Luminaires
Switches
3
Receptacles
Appliances
Use/Nature of SFR\ Wire Bathroom to include exhaust fan.
Work
"
Fees: Valuation
$200.00
Plan Approval
$0.00
Permit Fee Paid
$25.00
Issued By:
,pJr/<
Date 2/19/2007
D Permit Voided I
Parcelld # 1202900000
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 permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any neces approvals before starting such activity.
Signature Z '
Date
Agent/Owner
Address
OSHKOSH
WI 5490 - 3751 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 r~ceived. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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City of Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1 ~30
Phone'(920) 236-5050
Fax (920) 236-5084
~
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
nonnal pennit fee, which ever is greater.
OR
[fvou are a contractor participatinf{ in the Permit Fee Account Svstem and have adeQuate funds. check here
ifvou want this processed throuf!h vou~ account 0' ,
DATE .2. '- /. 7~ 07
JOB ADDRESS /,:;l.) 7 JAC4fC)/J
OWNER . 1/ JL'i-tJ,J1 1::)" &112 2YJ~
CONTRACTOR' ~ e rP-
J:L.,
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CHECK Ja ALL APPUCABLE
USVATEGORY
J,3Single Family DDuplex
DMulti-Family
DRental
DCommercial
OIndustrial
'SERVICE DNew
DChange
DTemporary
DNot Applicable
TYPE DOverhead
OUnderground
DNot Applicable
, FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
. Volts
:phase
:Amps
I
Circuits #
Fixtnres #
CHECK Ja ALL APPLICABLE
ORange
OFan OR Blower
OMotors
ODishwasher
OFumace
OGas Pumps
OGarbage Disposal
DAlC
DOther
DDryer OWater Heater
DElectric Sign
DESCRIPTION OF ALL WORK BEING DONE
. . VALUE (Including labor and all materials including light fixtures) $ "'~_ih:':)"'~-"-'~---"----"
MASTERELECTRICIAN S.-e \,~- O'~ (~...,~N~
3/02