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OSHKOSH
ON THE WATER
Job Address 530 W 9TH AVE
CITY OF OSHKOSH
No
125601
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner GARY BASLER REV TRUST
Create Date 07/02/2007
Contractor MY ELECTRIC CORP
Category 643 - Commercial-Addition/Remodels
Plan
Service
b New
o Change 0 Temp
. N/A
Type 0 Overhead
o Underground
Volts
Circuits
Luminaires
Amps
Switches
Receptacles
Appliances
Use/Nature of COMM / SEPARATE CIRCUITS
Work
Fees: Valuation $500.00
Issued By: ~ 8-
Plan Approval
$0.00
Permit Fee Paid
$25.00
Date 07/02/2007
o Permit Voided I
Parcel Id # 0601030000
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. t.hiS per.~.i~<l~~~:',:,~ n ~.~t~~~~~sement, the ~it.y strongl.Y ~~ges the permit applicant to contact the easement ~!o
holder(s) and}o. ~~.!!IEJ;.. S>' ary appr~ before..:~.~.~.I~~.~,~S~.9Q.ti\l~._____............
SignatureoC':"/' . ~__--_.--_..-.. Date ~ Z. () 1
Agent/Owner
Address
1512 RUGBY ST
OSHKOSH
WI 54902 - 6360
Telephone Number (920) 231-0707
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 Osl1kosh
Di~sion of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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OfHKOfH
O~"' THE WATER
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.'s"'x,~~
OR
If you are a contractor particioating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account 0 ., ..,
DA TE712/2007
JOB ADDRESS530 W. 9th Ave.
OWNERAutomotive Supply Co. Inc.
CONTRACTORMY Electric Corp.
CHECK Ii1 ALL APPLICABLE
USE CATEGORY
OSingle Family
SERVICE DNew
DChange
DDuplex DMulti-Family
DTemporary
DNot Applicable
DRental I2lCommercial DIndustrial
TYPE DOverhead DNot Applicable
OUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
V 0lt5 I
Phase
Amps _
Receptacles #_
Circuits #_
Switches #_
Fixtures #_
CHECK Ii1 ALL APPLICABLE
ORange
OFan OR Blower
DMotors
ODishwasher
DFurnace
DGas Pumps
DGarbage Disposal
DNC
DOther _
ODryer OWater Heater
OElectric Sign
DESCRIPTION OF ALL WORK BEING DONE_
Separate circuits.
VALUE (Including labor and all materials including light f"IXtures) $500.00
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MASTER ELECTRICIAN