HomeMy WebLinkAbout0127669-Electric (repair)
G
OSHKOSH
ON THE WATER
Job Address 524 W NEW YORK AVE
CITY OF OSHKOSH
No
127669
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
KELLY BURNETT
Create Date 11/06/2007
Contractor
CUMINGS ELECTRIC INC
o New.__ . Change 0 Temp
Category 634 -B.~sidentia!::.Service Chang~__
Plan
Service
ON/A
Type___.9Y~rI1~ad __~_____O_lJnd_~~9r9_u_n_~____
Volts
Circuits
Luminaires
Amps
200
Switches
Receptacles
Appliances
1------------------
I
L...-
----"-"-.-.-------.--.'.-----.-.-----,-.-----.---.---._._._--_._._.,-_...--..,---,--~-_..._-_.,._---.._..-.._--.-'-----.-...----.--...-.
i
i
I
I
I
_J
Use/Nature of ISFR lRepair service damage. **DEBIT ACCT**.
Work I
i
i
I
i
I
-l
I
i
I
I
I
I
I
i
~--------j
Fees: Valuation
$1,000.00
~?()o
Plan Approval _~~O.OO
Permit Fee Paid __ $60.Q.Q
Issued By:
Date 11/06/2007
---
o PermitVoi~
Parcelld # 1203070000
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 jf the inspection is not performed within two business days from the time the project is ready.
CUMINGS ELECTRIC, INC.
920-722-0769
p.2
~
OJHKOfH
~iV:Slon of Inspection Serv:ces
215 Church Avemle
2.C-. Bo>~ 2.:'3':;
ON 11-.1:-......./.,If...
Osjkosh, WI 3~903-1130
F2X ( 520) 236- 5084
P~one (920) 236-50~6
ELECTRICAL PERMIT APPLICATION
All in:or~2t~cn after bo:d categories DUS~ te ?rov~ded.
Incomplete ~pplicatio~s will net be processec_
JOB ADDRESS 524 r.. New York
OWNE R Kelly Burnett
CONTRACTOR CUMINGS ELECTRIC INC.
DATE 11/6/07
J8B NO. 2943
CHECK ALL APPLICABLE
USE CATEGORY:
SINGLE: ?ANILY~
COl'uJl-lIERC LZI.L[]
DOPLEX[] MULTI-?N0ILY[] ~E~~AL[]
INDUSTRIF_L[]
SERVICE: NEVi' 0 :::::HANGE [gJ
TEMPORARY [J NOT APPLICABL~ []
TYPE:
OVEREEAD [ZJ
UN DERGROUND 0
NOT APPLICABLE []
NUMBER OF ?IXTURES
S~ITCE::;S
RECEP?p.CL~S
CIRCUITS
AMPS 200
VOLTS /
PHASE
CHECK ALL APPLICABLE
R.l'",NGE D
"'lAT2R H3_>:'._TER D
G.~~BAG3 DIS?OSAI.. D
DRYER 0
Ale 0
DISHWASHER D
FAN OR BLOWER [] ~URNACE []
ELECTRIC SIGN D
MOTORS [] GAS PU[l.fPS D
CTHE?
DESCRIPTION OF ALL WORK BEING DONE Repair Service Damaoe
VALUE (Including labo= and all materials including light fixtures) $1000.00
FERMJ:T F3S:
MASTER ELECTRICLZlli RICHARD J WENZEL
Submit paymer:.t \'-"i th applicatior__ Fa:..lu::::e to pay within 3D days '11:"11 res".]l t i.n
fees beinq doubled 0:::: $lOO.OC plus the nermal ?erm~t fee, which ever is greater.
OR
Check .h.ere if you 'iVant this l:Jl....ocessed t.hro'.1i;;h jlOlJr a:::cou:.t 0
#lCC-0750-2515-80000