HomeMy WebLinkAbout0125789-Electric (3-seasons room)
~o~
OSHKOSH
ON THE WATER
Job Address 1565 DEERFIELD DR
CITY OF OSHKOSH
No
125789
ELECTRIC PERMIT - APPLICATION AND RECORD
MARK A KLEIN
Create Date OS/25/2007
Owner
Contractor
HOMEOWNER
Category 612 - Residential-Single Family Addition/R Plan
Service
b New
o Change
o Temp
. N/A
Type
o Overhead
o Underground
Volts
Circuits
2
6
Luminaires
3
10
Amps
Switches
Receptacles
Appliances
Use/Nature of SFR/ Constructing a 16'x20' three seasons room on the rear of the house. *18" piers will be installed. An exit will be provided onto the
Work ~xisting 12'x16' deck. Code compliant electric will need to be installed. A seperate permit will be required.
Fees: valuatiY1 ~$1,000.00 Plan Approval
'os"ed By. ~ ~ ~ 1" +'-' -
D Permit Voided I
$0.00
Permit Fee Paid
$60.00
Date 7/13/2007
Parcelld # 1320070000
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 approvals before starting such activity.
Signature 1M /
r-Aj;nt/owner
Address OSHKOSH
Date
,_ \:.- 0"
~ 5490 - 8277
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
[fvou are a contractor "articipatinf! in the Permit Fee Account System and have adequate funds. check here
ifvou want this "rocessed throuf!h YOUr account D' .
DATE
'1-"i~'C-{
.rOB ADDRESS
f .; (.S De..c..r ~ ,'d cJ
OWNER. M:;;..s-\(.. \=( \~.~
CONTRACTOR ~ e... -\ ~ R. c ~ "'-0 . p .-\
CHECK g ALL APPUCABLE
USE CATEGORY
fE:J6ingle Family DDuplex
DMulti-Family
DRental
o Commercial DIndustrial
'SERVICE DNew
o Change
OTemporary
ONot Applicable
TYPE DOverhead
DUnderground
ONot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
" Volts
:phase
Amps
I
I ~ p.. ......f G)
Receptacles # t D
Switches # L,
Circuits # ....,. p.<.l --.\ "",b\1:..
FixtUres # -3
CHECK ItJ ALL APPLICABLE
ORange
OFan OR Blower
OMotors
ODishwasher
OFumace
DGas Pumps
DGarbage Disposal
DAlC .
DOther
ODryer OWater Heater
OElectric Sign
DESCRIPTION OF ALL WORK BEING DONE ~ Sea.'5t-."': -\c",,~ to- ""~':::::::'~"...-t~.....T"'I.
-\:..c::>....'~~d ~ . CA-\"'t
,",V ALUE,(Including labor and all materials including light ilXtures) $ \,006
,MAsTER ELECTRICIAN
3/02
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