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o
OSHKOSH
ON THE WATER
Job Address 657 W 4TH AVE
CITY OF OSHKOSH
No
124203
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
TIMOTHY J/KARI A RUSCH
Create Date 04/13/2007
Category 612 - Residential-Single Family Addition/R Plan
Contractor
HOMEOWNER
Service
b New
o Change
o Temp
. N/A
Type 0 Overhead
o Underground
Volts
Amps
Circuits
Switches
Luminaires
Receptacles
Appliances
Use/Nature of SFR\ Wire new detached garage according to current codes.
Work
;.J " !
Fees: Valuation . 11::' $300.00
Issued By: 4/2. .~
.
Plan Approval
$0.00
Permit Fee Paid '$25.00
Date 4/13/2007
o Permit Voided .1
Parcelld # 0603480000
.
The undersigned, in applying for an Electric Permit to perform electrical work within a single family home, owned and occupied
as the principle residence by the undersigned, hereby acknowledges per City Municipal Code Section 11-22, that other
individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the
City of Oshkosh to perform said work.
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 "1 ~ j7~ ~ Date !f-/J-d7
Agent/Owner
Address
OSHKOSH
~ 549Q - __5_8~ Telephone Number
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
~
OJHKOfH
ON THF WATER
ELECTRICAL PERMIT APPLICATION
All infonnation 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 pennit(s) will result in fees being doubled or $100.00 plus the
nonnal pennit fee, which ever is greater.
OR
Ifvou are a contractor Darticipatinf! in the Permit Fee Account Svstem and have adeo.uate funds. check here
if you want this processed throuf!h va";' account D. . .
DATE t{-I J-. /)7 .
JOB ADDRESS
OWNER. "in
If? LV
ICI'"S'cA
l(t-h
c;r V" t>
CONTRACTOR (J k--/l e r
CHECK ra ALL APPUCABLE
USE CATEGORY
~ingle Family DDuplex
DMulti-Family
DRental
DCommercial
OIndustrial
..SERVICE DNew
DChange
DTemporary
~ot Applicable
TYPE DOver head
DUnderground
~ot Applicable
. FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
I
Receptacles #
Circuits #
. Volts
:phase
AmPs
Switches #
Fixt1i.res #
CHECK ra ALL APPLICABLE
DDishwasher
DFumace
OGas Pumps
DESCRIPTION OF ALL WORK BEING DONE It/,'re
ORange
DFan OR Blower
OMotors
DGarbage Disposal
DAlC
OOther
DDryer tJWater Heater
DElectric Sign
/l -e .....
q a/"4JI-e
, .
. . VALUE (Including labor and all materials including light f'rxtures) $ J pO
MAsTERELECTRICIAN 7~ P _ ~
3/02