HomeMy WebLinkAbout0124417-Electric (a/c)
G
OSHKOSH
ON THE WATER
Job Address 1816 MOUNT VERNON ST
CITY OF OSHKOSH
No 124417
ELECTRIC PERMIT.. APPLICATION AND RECORD
Owner
VICKIE M POLLNOW
Create Date 04/20/2007
Contractor
MANTHEY ELECTRIC INC
Category 612 - Residential-Single Family Addition/R Plan
Service
p New
o Change 0 Temp
. N/A
Type 0 Overhead
o Underground
Volts
Circuits
Luminaires
Receptacles
Amps
Switches
Appliances
Use/Nature of SFR / Wire new AlC unit.
Work
Fees: Valuation
$220.00
~
Plan Approval
$0.00
Permit Fee Paid
$25.00
Issued By:
Date 04/25/2007
D Permit Voided I
Parcelld # 1503320000
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
83 BRYN MAWR CIR
FOND DU LAC WI 54935 - 2926
Telephone Number 920-922-9618
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.
~
Oft-KOJH
ON THE WATEIl
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
Phone (920) 236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE l-.\....\ 8 ~O?
JOB ADDRESSJ ~ It:, 0\00\1)\ V ~n)oA)
OWNER \J \ c.. K \ ~ \PO L.L. mo<u
CO~"'TRACTOR fY\f:\f\.)'\' H ~"'< Eh~~~~'\X-.. \ IV <:.. _
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY DUPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE
NEW
CHANGE
TEMPORARY
NOT APPLICABLE
TYPE
OVERHEAD
UNDERGROUND
NOT APPLICABLE
NO. OF FIXTURES
SWITCHES
RECEPTACLES
CIRCUITS
/
PHASE
A..To.!P S
VOLTS
CHECK ALL APPLICABLE
RANGE
WATER HEATER
GARBAGE DISPOSAL
DRYER
DISHWASHER
FAN OR BLOWER
FURNACE
AI c-1t
ELECTRIC SIGN
MOTORS
GAS PUMPS
OTHER
DESCRIPTION OF ALL WORK BEING DONE ~ttl~
ro~
~~
b~
(IN 't \
.
Submit payment with application.
fees being doubled or $100.00 plus the
greater.
FailBECE1\lEns
norma~PR:r61oofe, which
will result in
ever is
VALUE
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
(Including '~ and all mater\~ including light fixturea) $ '2.. 2. 0 ,0 0 u \1
ELECTRICIAN~h Q'1 G'\l\o..~ It'"'.
"~ F .f,;(5 JJO '*\ IT'
MASTER