HomeMy WebLinkAbout0124157-Electric (upgrade)
G
OSHKOSH
ON THE WATER
Job Address 533 W 12TH AVE
Contractor B & H ELECTRIC
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
No
124157
Owner
JOHNNY/LISA A COATS
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Create Date
Jlan
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04/11/2007
Category 634 - Residential-Service Change
ON/A
Type . Overhead
o Underground
iL . .
ummalres
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I Receptacles
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Service
o New . Change 0 Temp
120/240
Circuits
Volts
Amps
100
Switches
Appliances
Use/Natu", of rFR\ S_"'oo 'pg..de
Work _
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Fees: Valuation
Issued By: Ark,
$1,000.00
Plan Approval
$0.00
Permit Fee Paid ;
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$60.00
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Date 04/11/2007
o Permit Voided I
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parcelld # 1301520000
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In the performance of this work I agree to perform all work pursuant to rules governing the described construction. I
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the W9rk
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 ~./'- ~'- _ ~h ~ Date I '(- 11- () 7
Agent/Owner
Address
5421 NICKELS DR
OSHKOSH
WI 54904 - 9530
Telephone Number q82-0303
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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), yo~r Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is rec~ived. Work may
continue if the inspection is not performed within two business days from the time the project is read~.
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. 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 pennit(s) will result in fees being doupled or $100.00 plus the
nonnaI pennit fee, which ever is greater. I
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OR l
[fvou are a contractor "artici"atin~ in the Permit Fee Account System and have' adeQuate funds. check here
ifvou want this processed throuf!h your account 0 :
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DATE~
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ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
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OJHKOfH
I ON THF WATER
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City of Oshkosh
Divisiori. of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone'(920) 236-5050
Fax (920) 236-5084
JOB ADDRESS S,~ ~ w ) L~
OWNER' ~ () t-I.-(J ('~ (') ^ TS
CO~CTOR ~ 4 (-\ f=-'-fJTt \L
CHECK 6ZI' ALL APPUCABLE
USE CATEGORY
rdSfngle Family
'SERVICE DNew
Dehange
DTemporary
DNot Applicable
TYPE OOverhead
OUnderground
OCommetcial OIndustrial
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DN~t Applicable
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ODuplex
OMulti-Family
ORental
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
. Volts 120 I 2. ~D
:Phase ~ [rOGLt:-"
:Amps t on
Receptacles #
Circuits #
FlXtU.res #
.1-.
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Switches #
CHECK G!J ALL APPLICABLE
ORange
OPan OR Blower
OMotots
ODishwasher
OFumace
OGasPumps
DGarbage Disposal
DAlC
LJOther
, ' I
DDryer ~Water Heater
DElectric Sign ! '
DESCRIPTION OF ALL WORKBEfN'GD(JNE
Stfo lCtu~ b~..it~ C
.' V ALl;JE (Including labor and all materials including light fixtures) $ 1 {) 0 0 . D 0
MASTERELECTRICIAN ~~<f;cJyt .?J ;J~
3/02