HomeMy WebLinkAbout0127630-Electric
G
OSHKOSH
ON THE WATER
Job Address 1319 OSHKOSH AVE
CITY OF OSHKOSH
No
127630
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
DANIEL W JENSEN
Create Date 11/0212007
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
Luminaires
Amps
Switches
Receptacles
Appliances
Use/Nature of SFRI Remodel 2nd floor bathroom - in floor heat, exhaust fan, GFCI protection - all wiring to be installed per current code.
Work
$25.00
Fees: Valuation
Issued By: ~~
$500.00
Plan Approval
$0.00
Permit Fee Paid
Date 11/2/2007
D Permit Voided I
Parcelld # 1600250000
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 c e any n essa approvals before starting such activity.
Signature
Agent/Owner
Date II /~ /2 00-:;-
f {
Address
OSHKOSH
WI 5490 - 2632 Telephone Number 920-948-7631
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 ofInspection Services
P.O. Box 1130
Oshkosh, VVI54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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ON THF WATFR
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.
OR
If vou are a contractor participating in the Permit Fee Account Svstem and have adequate funds. check here
if vou want this orocessed throuf!h vour account 0
DATE
it J 2!;?, 6 c) ;2..-
( I
JOB ADDRESS 1)1 C? o<;kho~~
OWNER J~Ot f'. JeffL5 e1
CONTRACTOR (!)CA./ V'\.Er
-~
CHECK Ii:1 ALL APPLICABLE
~ CATEGORY
~gle Family DDuplex DMulti-Family
SERVICE DNew o Temporary
DChange DNot Applicable
DRental
DCommercial
DIndustrial
TYPE DOverhead
DU nderground
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
I
Receptacles #
Circuits #
Volts
Phase
Amps
Switches #
Fixtures #
CHECK Ii:1 ALL APPLICABLE
ORange DDishwasher DGarbage Disposal
DFan OR Blower DFurnace DAlC
DMotors DGas Pumps DOther
DESCRIPTION OF ALL WORK BEING DONE t>~ Ode[A~
DDryer DWater Heater
DElectric Sign
~.J:-i-\ 1'0 Oyv-\
MASTER ELECTRICIAN
. ht fixtures) $ go 0
VALUE (Including labor and all m
3/02