HomeMy WebLinkAbout0122506-Electric
e
OSHKOSH
ON THE WATER
Job Address 2021 MOUNT VERNON ST
CITY OF OSHKOSH
No
122506
ELECTRIC PERMIT - APPLICATION AND RECORD
o Change 0 Temp
Owner PATRICIA A NOURSE Create Date 10/19/2006
Category 611 - Residential-New Single Family Wirin Plan
ON/A Type o Overhead . Underground
Circuits 25 Luminaires 30
Switches 30 Receptacles 50
Contractor ELECTRICAL CONTRACTING SPECIALI;
Service
Ie New
Volts 120/240
Amps 200
Appliances Range, dishwasher, fan, fumace, garbage disposal, AlC, dryer
Use/Nature of NSFD/ New single family* with 2 car attached garage, 12' x 12' patio, 20' wide driveway.
Work
Fees: Valuation
$4,300.00
(}/Y)(AJ
Plan Approval
$0.00
Permit Fee Paid
$128.00
Issued By:
Date 11/13/2006
o Permit Voided I
Parcelld # 1515390000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address
PO BOX 42
BERLIN
WI 54923 - 0
Telephone Number 920-428-7000._
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless speCified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
~.
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone'(920) 236-5050
Fax (920) 236-5084
~
OJHKOfH
ON THF WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be proce$sed.
. 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
normal permit fee, which ever is greater.
OR
If vou are a contractor participatinf{ in the Permit Fee Account System and have adequate funds. check here
if you want this vrocessed throuf!h vour account D. .
DATE If h/ot
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JOB ADDRESS Z-l> Z-t Mr. i/~k.DM
OWNER' 1/- ~/~~"""
. CONTRACTOR e (!..5
CHECK if ALL APPLICABLE
USE CATEGORY
('1.ElSingle Family DDuplex OMulti-Family
. SERVICE. 'iaNew DTemporary
DChange DNot Applicable
ORental
o Commercial
OIndustrial
TYPE DOverhead
~Underground
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
, Volts
:phase
AmPs
Receptacles # $0
Switches # :J 0
Circuits # ;J...r'
(2.0 I 2.q'q
I
Zoo
FixtUres # ~o
CHECK 1tI ALL APPLICABLE
~ge
/l, ti:lFan OR Blower
OMotors
)m>ryer OWater Heater
DElectric Sign
~Dishwasher
~Furnace
OGas Pumps
,l8lGarbage Disposal
!SAlC
DOther
DESCRIPTION OF ALL WORK BEING DONE }./ S' Fl2..
r'T ALUE (Including labor and all materials including light fixtures) $ 4 $ 0-0
MASTERELECTRICIAN ~ --:-S::..<~
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