HomeMy WebLinkAbout0123742-Electric (2nd flr remodel)
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OSHKOSH
ON THE WATER
Job Address 438 W 11TH AVE
CITY OF OSHKOSH
No
123742
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
MATTHEW LEBOUTON/JACQUELlNE DUS Create Date 03/08/2007
Contractor
DREXLER ELECTRIC
Category 612 - Residential-Single Family Addition/R Plan
Service
p New
o Change 0 Temp
. N/A
120
Circuits
Type 0 Overhead
2
6
o Underground
Volts
Luminaires
5
16
Amps
20
Switches
Receptacles
Appliances
UselNature of SFR 1 2nd floor remodeling.
Work
Fees: Valuation
$1,230.00
~
Plan Approval
$0.00
Permit Fee Paid
$77.00
Issued By:
Date 03/08/2007
D Permit Voided I
Parcelld # 0906480000
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
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address
490 COUNTY ROAD FF
PICKETT
WI 54964 - 0
Telephone Number 920-589-6700
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
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
(I)
OJHKOJH
ON THE WATER
· 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
I ou are a contractor artici atin in the Permit Fee Account S stem and have ade uate unds check here
if vou want this processed through your account D
JOB ADDRESS Rf 3 r U, II -1--'... 1/ V-(#I/tt.-..
OWNER fJ1 J4'1r U b ovl-orJ
CONTRACTOR 11)~/:;?<L eYL uec-rfl-/C
DATE
3- t-o 1
CHl~CK 0 ALL APPLICABLE
USE CATEGORY
~Single Family
SERVICE ONew
o Change
DDuplex
DMulti-Family
DRental
DCommercial
DIndustrial
o Temporary
~ot Applicable
TYPE OOverhead
OUnderground
J8Not Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts /2@ /
Phase .:I- >
Amps I ~/ 2--0
I
Receptacles # I /0
Switches # ~
Circuits #
d--
S-
Fixtures #
CHECK 0 ALL APPLICABLE
ORange
OFan OR Blower
DMotors
ODishwasher
OFumace
DGas Pumps
DGarbage Disposal
OAlC
D Other
DESCRIPTION OF ALL WORK BEING DONE
Z NO
P/~ v vz..
o Dryer OWater Heater \(~
DElectric Sign 1; '1
~ * \Q
)?e'p-~L{)/.~ .
REC€lVED
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN .~( \:)O~
rJ... 3 0 ,
f
Od
MAR () f a- 00'/
DEPARTMENT OF
COMMUNITY DEVELOPMENT
"77, ,-
3/02