HomeMy WebLinkAbout0125014-Electric (service change)
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OSlHKOSH
ON THE WATER
Job Address 155 W 23RD AVE
CITY OF OSHKOSH
No
125014
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner SHANNON L ESTNESS
Create Date 05/29/2007
Contractor HOMEOWNER
Category 634 - Residential-Service Change
Plan
. Change
o Temp
o NIA
Type
. Overhead
o Underground
Service
b New
120/240
Circuits
Luminaires
Volts
100
Switches
Receptacles
Amps
Appliances
Use/Nature of iSFR 1 Service Change
Work
Fees: Valuation $900.00 Plan Approval
IsslledBy: J~~
$0.00
Permit Fee Paid
$53.00
Date 5/29/2007
n Permit Voided I
Parcelld # 1403050000
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.
Iln 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 ecure any necess ap ovals efore starting such activity. (/\/7. J....
Signatur Date -5 /Dfl127
Agent/Owner
Address
OSHKOSH
~ 5490 - 0000 Telephone Number
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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 withoutpennit(s) will result in fees being doubled or $100.00 plus the
nonnal permit fee, which ever is greater.
OR
I ou are a contractor artici atin in the Permit Fee Account S stem and have ade .uate unds check here
ifvou want this DTocessed throuf!h vour account 0
DATE~/d~,/07
JOB ADDRESSJ.S S W dE rJ II (J-t
OWNERCS\r\ru\.f\OYl ctiJrirul &hrn;e~
CONTRACTOR
CHECK 6ZJ ALL APPLICABLE
USE CATEGORY
~Single Family
I
..SERVICE. Oyew
~hange
DDuplex
DMulti-Family
DRental o Commercial o Industrial
TYPE ~erhead ONot Applicable
OUnderground
DTemporary
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
. Volts I~ I a. '-{
):lhase l q
~mps ( E:> c::> .Pr-
Receptacles #
Circuits #
Switches #
FixtUres #
CHECK 6ZJ ALL APPLICABLE
ORange
OFan OR Blower
DMotors
DDishwasher
DFumace
DGas Pumps
OGarbage Disposal
ONC .
DOther
ODryer DWater Heater
OElectric Sign
DESCRlPTIONOFALLWORKBEINGDONE \ W1'afip L_Ofl11r-(l ~ cb
JOn f~ lore(~ . u -
?~-.r '\:~ ~~'G .'-.:>1, ~.,.~C~~
. . VALUE (Including labor and aU materials including light lIxtures) $
MASTER ELECTRICIAN
3/02