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OSHKOSH
ON THEWATER
JobAddress 18 EMELVIN AVE
Contractor QUALITY ELECTRIC
CITY OF OSHKOSH
ELECT'RH:PERMIT - APPLlCAT'IONANO RECORD
No
126983
Owner' BRADLEY J/MELlSSA A NOVAK
Create Date 09/27/2007
- 'Category 612 - Residential-Single Family Additiori/R Plan
Service
. N/A _ '-1
Type 0 Overhead
0- Underground
Volts
~ew 0 Change 0 Temp
120/240
100
Circuits
Luminaires
Amps
Switches
Receptacles
8
------.-
Appliances
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I
I
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-1
Use/Nature of ISFR / MISC. WIRING IN THE HOUSE **check #4216
Work
I
,
Fees:
$800.00
Plan Approval
$0.00
Permit Fee Paid
$46.00
Issued By:
Date 09/27/2007
D Permit Voided I
Parcelld # 1001390100
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 Date
AgenUOwner
Address 3750 GLENBROOK LN
OSHKOSH
WI 54904 - 8517
Telephone Number (920) 410-589~
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.), Acces~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 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 fuspectionServices, PO Box 1128,
Oslikosh WI 54903-1128. Commencing work without pennit{s) will result in fees being doubled or $100.00 plus the
Donnal pennit fee, which ever is greater.
OR
lfvou are a contractor Darticipatin!! in the Permit Fee Account Svstem and have adeQuate funds. check here
ifvou want this Drocessed throu!!h vour account 0" .
DATE 9--::2 7---.01
I '\.) /" ..J.._- 11 "to .
JOB ADDRESS ! ~. t::'t45 ( 0 n J (? Vi N 0 {i\ V-e ,
(?". ~ 0', 0
.. :::cr~:a-G~ ?~~O ~)~ct~J () VCA ,;
CHECK fa ALL APPUCABLE
USE CATEGORY
~Single Family
,"SERVICE DNew
DChange
ODuplex
DMulti-Family
ORental
o Commercial OIndustrial
DTemporary
DNot Applicable
TYPE DOverhead )(1Not Applicable
DUndergro1.md
" FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
. V oJts /2 't t'zl./t;1
:phase J
:Amps Ie "
Receptacles # "8
Circuits #
Switches #
FixtUres #
CHECK fa ALL APPLICABLE
ORange
DFan OR Blower
OMotors
ODishwasher
)JFumace
DDryer DWater Heater
DElectric Sign .
MASTER ELECTRICIAN
YG: If d 4'(
. . VALUE (Including labor and aU materials includin
3/02