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OSHKOSH
ON THE WATER
Job Address 1213 WASHINGTON AVE
CITY OF OSHKOSH
No
125831
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
RONALD B MARKS
Create Date 07/17/2007
Contractor
YOURR ELECTRIC
Category 612 - Residential-Single Family Addition/R 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 SFR\ Family room addition and trench single ckt. to garage.
Work
Fees: Valuation
$1,697.00
Plan Approval
$0.00
Permit Fee Paid
$77.00
Issued By:
frl c:'
Date 07/17/2007
D Permit Voided I
Parcelld # 0203470000
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 a plication within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and t y necessary p. rova ,before starting such activity. 1 I !o
Signature' Date !L1 '01
/ I
Agent/Owner
Address
PO BOX 311
DALE
WI 54931 - 311
Telephone Number (920) 779-6989
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 of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1~30
Phone'(920) 236-5050
Fax (920) 236-5084
~
OJHKOfH
ON THF WATER
ELECTRICAL PERMIT APPLICATION
All infonnati~n 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 permit fee, which ever is greater.
OR
Ifvou are a contractor DarticiDatinf! in the Permit Fee Account Svstem and have adeQuate funds. check here
ifvou want this processed throuf!h vour account D' ,
---- ,
DATE\../cJ2'(f I~O 7
JOB ADDRESS
OWNER'
CONTRACTOR
[)!3
f
u..}"dJ{Nj IaJ 51;
E~dvt~' ~
L(~~
CHECK ef ALL APPLICABLE
USEftTEGORY
JtJ5ingle Family DDuplex
DMulti-Family
o Rental
DCommercial
o Industrial
SERVICE ONew
OChange
OTempormy
ONot Applicable
TYPE DOverhead
OUnderground
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
I
Receptacles #
Circuits #
, Volts
:phase
~mps
Switches #
FixtUres #
CHECK ef ALL APPLICABLE
ORange ODishwasher DGarbage Disposal ODryer OWater Heater
OFan OR Blower OFumace ONC DElectric Sign
OMotors DGas Pumps . DOther _ __
DESCRIPTION OF ALL, . WOIDCBElNGDONE ~~~~WI~ <-
Gj);Q (lu1tl(,!-1Y. (Ic) ili(l ~~ ~~{U__' 'atp
. . VALUE (Including labor and all materials including Ught IlXtures) $ ! (P 91, rt:l-
.
MASTERELECTRICIAN . @e- il{CLtL. .
3/02