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OSHKOSH
ON THE WATER
Job Address 1214W6THAVE
CITY OF OSHKOSH
No
123842
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
DIANNA M GRIESBAUM
Create Date 03/14/2007
Contractor
DILLMAN ELECTRIC
Category 612 - Residential-Single Family Addition/R Plan
Service
b New
o Change 0 Temp
. N/A
Type 0 Overhead
o Underground
Volts
Circuits
Luminaires
Amps
Switches
Receptacles
Appliances Motor for hot tub, exhaust fan.
Use/Nature of SFRI Converting the existing attic area into a master bedroom, closet and bathroom. Wire accorCling to code with recepts., lighting,
Work ncluding a subpanel.
Fees: Valuation . $1.;WO.Oq
Issued By: # r//
Plan Approval
$0.00
Permit Fee Paid _ $77.00
Date 03/19/2007
o Permit Voided I
Parcel Id # 0609720000
I
In the performance of this work I agree t9 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 re any nece~prQY s before starting such activity.
Signature , Date
Agent/Owner
3/}0/07
I I
Address
PO BOX 0273
OSHKOSH
WI 54903 - 273
Telephone Number 920-212-0756
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
~
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 withoutpermit(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 participatinf! in the Permit Fee Account System and have adeo.uate funds. check here
ifvou want this processed throuf!h YOUr account D' "
DATE~
JOBADDRESS \~\L\ ~. LR~
OWNER " ;D/;\v v.... d r; rr\.(! strrl-t y-,-:., .
CONTRACTOR \)~\\\I'-\.a..Y\. b\e<:.t-v~: c..
CHECK ~ ALL APPUCABLE
USE CATEGORY
IilISingle Family DDuplex
OMulti-Family
DRental
o Commercial
OIndustrial
. SERVICE DNew
DChange
DTemporary
DNot Applicable
TYPE DOverhead
DUnderground
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
I
Receptacles #
Circuits #
" Volts
:phase
Amps
Switches #
FixtUres #
CHECK ~ ALL APPLICABLE
ORange
6'lFan OR Blpwer
tilMotors
ODishwasher
OFumage
DGas Pumps
DGarbage Disposal
DAlC
DOther
DDryer OWater Heater
DElectric Sign
~CRlPo TI01~LWo ORKBoEINGDONE_~t\ ro' :\f'~~5
ec\"'~ ~~r~. A..dd. S V\e ".
-+6'(
A-K- i C-
"" VALUE (Including labor and all materials including light IlXtures) JJfl.b0 at;>O
MASTERE~CTRICIAN 1)\f'U3_~ '\) 1 \\. \IlA.~'^'-
3/02