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OSHKOSH
ON THE WATER
o Change
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECOR.D
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Owner LORI J ADAMS I Create Date OS/29/2007
Category 623 - Residential-Duplex Addition/Remd:- Plan
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Type 0 Overhead r-o Underground
I Luminaires
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No
125030
Job Address
1020 1022 MALLARD AVE
Contractor
BOWMAN ELECTRIC LLC
Service
b New
o Temp
. N/A
Volts
Circuits
Amps
Switches
Receptacles
Applliances
Use/Nature of 'Duplex! 1020 side/ Remodel the kitchen* wire to current code.
Work
Fees: Valuation
$1,500.00
Plan Approval
$0.00
Permit Fee Paid
$25.00
Issued By:
-r/<"
Date 05/30/2007
D Permit Voided I
Parcelld # 1523970000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction. I
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perfon+' the work
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described in this permit application within an easement, the City strongly urges the permit applicant to contact the ~asement
holder(s) and to secure c approvals before starting such activity. I ~
Signature . Date
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--. Agent/Owner I
Address 914 W 12TH AVE OSHKOSH WI 54902 - 0 Telephone Nun1ber 231-3106
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 entr.-), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the requesf is received. Work may
continue if the inspection is not performed within two business days from the time the project i~ ready.
City of Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone'(920) 236-5050
Fax (920) 236-5084
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OJHKOfH
ON THF WATER
OWNER-
CONTRACTOR 00vJ~-,^--- aec;h~J c
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. Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspectioh Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees be~g doubled or $100.00 plus the
normal permit fee, which ever is greater. I
OR . !
If vou are a contractor participatin1! in the Permit Fee Account Svstem and have ladeauate funds. check here
ifvou want this processed throu1!h vour account 0 I I ~. ".
DATEJS _}i);j7
JOB ADDRESS I () ]..0 YJ!1 ,.if u J II
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DCommefial OIndustrial
TYPE DOverhead i DNot Applicable
DUnderground I
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ELECTRICAL PERMIT APPLICATION I
All infonnation after bold categories must be provided.
Incomplete applications will not be processed.
CHECK Ii! ALL APPLICABLE
.US~TEGORY
~ingle Family DDuplex
OMulti-Family
DRentaI
'SERVICE DNew
DChange
OTemporary
~t Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Circuits J
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~t
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DDryer I DWater Heater
DElectric ISign
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,r;flf! 1//.'<-0 ~/.
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, Volts
]phase
~mps
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Receptacles #
Switches #
CHECK Ia ALL APPLICABLE
ORange
OFan OR Blower
DMotors
DDishwasher
DFurnace
OGas Pumps
DGarbage Disposal
DAlC
DOther
DESCRIPTION OF ALL WORK BEING DONE
,1(; 0L--
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;"-l/ ~ tJ 7 Z, a:L
~: 30 ->
_ . VALUE (Including labor and all materials including light iIxtures) $ /560
:MASTER ELECTRICIAN cq
3/02