HomeMy WebLinkAbout0124137-Electric (boiler circuit)
e
OSHKOSH
ON THE WATER
Job Address 20 W SMITH AVE
CITY OF OSHKOSH
No
124137
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
DAVID G/ROXANNE M NELSON
Create Date 04/09/2007
Contractor
QUALITY ELECTRIC
Category 612 - Residential-Single Family Addition/R Plan
Service
p New
120/240
Circuits
o Change 0 Temp
. N/A
Type 0 Overhead
o Underground
Volts
Luminaires
Amps
100
Switches
Receptacles
Appliances
Use/Nature of SFR / Service call to reconnect boiler circuit.
Work
Fees: Valuation $45.00
Issued By: ~
Plan Approval
$0.00
Permit Fee Paid
$25.00
Date 04/09/2007
D Permit Voided I
Parcelld # 1517860000
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 necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address
3750 GLENBROOK LN
OSHKOSH
WI 54904 - 0
Telephone Number 410-5890
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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
~
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 broughtto City Hall, Room 205 or mailed to Inspection Services. PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being doubled or $100.00 plus the
nonnal pennit fee, which ever is greater.
OR
1fvou are a contractor JJarticipatinrin the Permit Fee Account Svstem and have adequate funds. check here
ifvou want this TJrocessed throuf!h vour account D. .
" DATE ?,-5- .if 7
JOB ADDRESS ;2 0 \J -e5T Sm ,'fA ,.s:+~
OWNER. fJ,1 v"-€ 5{ /1{.}"I;:!:5c.V~ /1t>>fl>~9
CONTRACTOR ()u A C1'-;1 ~ Ie c:4; (
I
CHECK &! ALL APPUCABLE
. USJ>CATEGORY
laSingle Family ODuplex
rosA ka5/;J '\,J i J
.m!: jJ1f.5, fVel;to~
..SERVICE ONew
OChange
O'!'s:mponuy
laNot Applicable
TYPE OOverhead
DUnderground
o Commercial o Industrial
--.~...
9N'ot Applicable
OMulti-Family
ORental
. FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
"Volts /2 () 1240
fhase J
. Amps :J..{) 0
Receptacles #
Circuits #
Switches #
FixtUres #
CHECK &! ALL APPLICABLE
ORange DDishwasher OGarbage Disposal
OPan OR Blower DFumace ONC .
OMotors DGas Pumps DOther _ 6u ~ (....!-i.
DESCRIPTION OF ALL WORK BEING DONE S.-ev J i c.e.
. ED'; \ er C~ r 6u.-.\ t.
ODtyer OWater Heater
OElectric Sign
~cct1le.c~
~~II
-Ie) t: -e C;()/V -e:(r
\ 0"1
q \ E\' ~'7
IJ~r
. . VALUE (Including labor and all materials iD11Ud' gligh.
~f I
l../" I //
MASTER ELECTRICIAN j~
7
/- u~/:tJ{)
~<' if::7'
3/02