HomeMy WebLinkAbout0125509-Electric
e
O~HKOSH
ON THE WATER
Job Address 1275 JUDY LEE DR
CITY OF OSHKOSH
No
125509
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
THOMAS M/COURTNEY L WITCZAK
Create Date 06/26/2007
Contractor
HOMEOWNER
Category 612 - Residential-Single Family Addition/R Plan
Service
p New
o Change
o Temp
. N/A
Type
o Overhead
o Underground
Volts
Amps
Circuits
Luminaires
Switches
Receptacles
Appliances
Use/Nature of SFR\ Wire basement family room according to current code.
Work
Fees: Valuation
$500.00
Plan Approval
$0.00
Permit Fee Paid
$25.00
Issued By:
1ffr'
Date 6/26/2007
D Permit Voided I
Parcelld # 1342505600
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.
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 appro ersfarting such activity.
Date
~12c(0
Agent/Owner
Address
OSHKOSH
WI 5490 - 0000 Telephone Number
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 ofInspection 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 without pennit(s) will result in fees being doubled or $100.00 plus the
normal pennit fee, which ever is greater.
OR
lfvou are a contractor lJarticilJatinf{ in the Permit Fee Account Svstem and have adequate funds. check here
ifvou want this Drocessed throuf!h vou;. account D. .
DATE ~(Zt;/CI1
JOB ADDRESS
OWNER"
CONTRACTOR
1275 :JIJd1 lee
"~,/Y\ Wi k<"c, ~
() WA.tr
,
Dr.
CHECK ~ ALL APPLICABLE
USE CATEGORY
~ingle Family
. SERVICE. QNew
DChange
DDuplex
OMulti-Family
DRental
o Commercial
OIndustrial
DTemporary
DNot Applicable
TYPE OOverhead
DUnderground
DNat Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
" Volts
:phase
Amps
I
Receptacles #
Circuits #
Switches #
FixtUres #
CHECK ~ ALL APPLICABLE
ORange ODishwasher DGarbage Disposal
OFan OR Blower OFumace DAlC
OMotors OGas Pumps DOther
DESCRIPTION OF ALL WORK BEING DONE~(.e.GJI cti. {
DDryer DWater Heater
DElectric Sign
()vJ-kr.> ,
. 1
Ce fi'i-1.( l'thf-.5
MAsTER ELECTRICIAN
~oo
" " VALUE (Including labor and aU materials including Ii
3/02
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