HomeMy WebLinkAbout0124474-Electric
G
OSHKOSH
ON THE WATER
Job Address 1110 W 19TH AVE
CITY OF OSHKOSH
No
124474
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
MARK ErrHERESA BOETTCHER
Create Date 04/27/2007
Contractor
LEWINS ELECTRIC
Category 612 - Residential-Single Family Addition/R Plan
Service
o New
o Change 0 Temp
. N/A
Type 0 Overhead
o Underground
Volts
Circuits
Luminaires
Amps
Switches
Receptacles
Appliances
Use/Nature of ~FR / Finish off basement.
Work
Fees: Valuation
$3,195.00
~
Plan Approval
$0.00
Permit Fee Paid
$111.00
Issued By:
Date 04/27/2007
D Permit Voided I
Parcelld # 1311610000
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
1111 S MADISON ST
APPLETON WI 54915 - 1715
Telephone Number 735-1849
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 W^TER
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 without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If vou are a contractor "articipatin~ in the Permit Fee Account System and have adeouate funds. check here
if vou want this processed throu~h your account 0
DATE s-/ (/;;(a? 7
l I
JOB ADDRESS 1(1 CJ 6u p- sr- I C?.r::lf.- oS r-
OWNER i"fi:-/f R &- /5 0 6:- r-T elf ,,-/(
CONTRACTOR L&Lut#..r ,)St. 6-....CrI'C/C
CHECK ItJ ALL APPLICABLE
USE CATEGORY
~gle Family DDuplex
DMulti-Family
DRental
DCommercial DIndustrial
SERVICE ONew
OChange
OT~rary
~ Applicable
TYPE OOverhead
OUnderground
UIMOi Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts
Phase
Amps
I
Receptacles #
Circuits #
Switches #
Fixtures #
CHECK IiI ALL APPUC~LE
ORange
OFan OR Blower
DMotors
ODishwasher
'OFurnace
DGas Pumps
OGarbage Disposal
ONC
DOther
ODryer DWater Heater
OElectric Sign
DESCRIPTION OF ALL WORK BEING DONE ,F/ I!/'IJ'f1 d F"-.F: !.3Af'f;:h t-If//
VALUE (Inc:luding labor and all materials including light fixtures) $;? I P s-
/
MASTERELECTRICIAN ~iJr ~/29n./l
~i~'
~4
\
"tIn?