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OSHKOSH
ON THE WATER
Job Address 1849 NORTHPOINT ST
CITY OF OSHKOSH
No
127364
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
CLYDE JIWENDY S GRUSE JR
Create Date 10/18/2007
Contractor
CUMINGS ELECTRIC INC Category
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120/240 Circuits
634 - Residential-Service Change
Plan
Service
Type ___Ql/erh~<!sl_________________O Un_dergrou,:,d_______1
Volts
22 Luminaires
Amps
100
Switches
Receptacles
Appliances
Use/N.lo.. of iFR f CHANGE PANEL ONLY 1DDAMP TO 100AMP
Work
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**debt acct
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Fees: Valu~~_
Issued By: ..u.u )6
$475.00
Plan Approval
$0.00
Permit Fee Paid
$25.00
Date 10/18/2007
O_,=-ermit Void~
Parcelld # 1521730000
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
Agent/Owner
Address
PO BOX 749
NEENAH
WI 54957 - 749
Telephone Number 920-231-5946
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.
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CUMINGS ELECTRIC, INC.
920-722-0769
p.1
~
C1HKOJH
ON hll.: \I,,:.41E~
Jivision of :nspecticn Services
2.:'" Chu::ch A,"er:ue
P.O. 30x :':'3J
Oshkosh, w: 5~903-1130
Fax (92.0) 236-:'084
Phone (920) 236-~046
ELECTRICAL PERMIT APPLICATION
All in=orIct~on after bold categcries mus~ be ?rov~ded.
Incomplete cppl~catio~s will no~ be processed.
DATE 10/18107
JOB ADDRESS 1849 NORTHPOINT
Ov-;t-lER C J GRUSE
CONTRACTCR CUMINGS ELECTRIC INC.
JOB NO. 2869
CHECK ALL APPLICABLE
USE CATEGORY:
SINGLE F1'-lvIILYIZl
COIvJMERC IAL[]
Df.JP1~X[] MULI'I-FA.lYIILYD
INDUSTR:ll.L[]
RSNTAL[]
SERVICE: NEW [] CHANGE lSJ
TEMPORARY [] ~OT APPLICABLE []
TYPE:
CVERHEAD [ZI
UNDEEGP.OONC []
NOT APPLICABLE []
EECEPTACLES
erR::::::.JI':'S 22
NUMBER OF ?IXTURES
Sl'lITCH3S
AMPS 100
VOLTS 120/240
PHASE 1
CHECK ALL APPLICABLE
~~NGE [] WA~ER HEATER 0 GARBAGE DISPOSAL [J
DRYER D
DISHWASHER [] FAN OR BLOWER [] ?~RNACE []
Ale D
ELECTRIC S=GN [] !":iOTORS D GAS PUEFS D
OT~-rER
DESCRIPTION OF ALL WORK BEING DONE CHANGE PANEL ONLY. 100 AMP TO 100 AMP
VALUE (Including labor and all materials including light fixtures) $475.00
PERMIT FEE:
MASTER ELECTRICIAN RICHARD J WENZEL
SLbrnit paynent ~ith app~icction. Fai~ure to pay within 30 days will result in
fees being doubled or $lOO.CO plus the normal permit fee, which ever is greater.
OR
Check here if you want Lhis processed through yo~r acc~uP-t ~
#100-075)-25:5-8)OCC