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OSHKOSH
ON THE WATER
Job Address 1538 W 6TH AVE
CITY OF OSHKOSH
No
123556
ELECTRIC PERMIT - APPLICATION AND RECORD
Contractor
BULLSEYE ELECTRIC INC
b New . Change 0 Temp
120240
Owner PAUL D/DIANE L HOLLUB Create Date 12/12/2006
Category 612 - Residential-Single Family Addition/R Plan
o N/A Type . Overhead o Underground
Circuits 12 Luminaires 12
Switches 15 Receptacles 22
Service
Volts
Amps 100
Appliances Range, Fan or Blower, Dishwasher, Furnace, Garbage Disposal, AlC, Dryer
Use/Nature of BRF/ Addition* to add 2 additional bedrooms and convert an existing bedroom into a bathroom'and hallway.
Work
Fees: Valuation $4,400.00
Issued By: ~W
Plan Approval
$0.00
Permit Fee Paid
$128.00
Date 02/19/2007
D Permit Voided I
Parcelld # 0610890000
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
h~lder(S) and to secu~ny ne~a~provals before starting such activity.
Signature ~ ~~ Date d - / <tf- <::'?
Agent/Owner
Address
PO BOX 749
NEENAH
WI 54957 - 749
Telephone Number 920-231-5946
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 of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THE 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If YOU are a contractor particivating in the Permit Fee Account System and have adequate funds. check here
if YOU want this processed through your account 0
DATE ';;>-/</-t::Jq.
JOBADDRESS /'$"38 ~,<:;;-rH. ,4~.
OWNER ~<:. + L).r~1I.>6 /./~
CONTRACTOR ~~~~ ~c<!"cr.e:Ec,
CHECK Ii1 ALL APPLICABLE
USE CATEGORY
lSlSingle Family
SERVICE ONew
)aChange
\.
ODuplex
OMulti-Family
ORental
o Commercial
Olndustrial
OTemporary
ONot Applicable
TYPE IaOverhead
OUnderground
ONot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts
Phase
Amps
/~ I ;;)q'o
I
1tX)
Receptacles # ~ .J
Circuits #
/~
~ I;)..
Switches # I S
Fixtures #
CHECK Ii1 ALL APPLICABLE
lQRange
!!Fan OR Blower
OMotors
lQDishwasher
gpurnace
OGas Pumps
8Garbage Disposal
SAlC
OOther
)a'Dryer OWater Heater
OElectric Sign
DESCRIPTION OF ALL WORK BEING DONE 4LJL).Z7.];c?LJ ~A,.)D &~~<:.. .
~
VALUE (Including labor and aU materials including light fixtures) $ ~<:Y~ .
MASTER ELECTRICIAN d ~zg{
3/02