HomeMy WebLinkAbout0127942-Electric (city rehab)
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OSHKOSH
ON THE WATER
Job Address 655 MOUNT VERNON ST
CITY OF OSHKOSH
No
127942
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
KATHLEEN L SHAW
Create Date 11/12/2007
Contractor
QUALITY ELECTRIC
Category 612 - ResidentiaI:.Sin"~f~r:!!.iIJ'"Adcji!i~-'B
Plan
o Change_ O=Te~I:_-=.:B:/~___J
Type 0 Ov_er~El_C1.<!_ .______O.Ulldergrl?LJlld
Service
rJ N~~_"
120/240
Circuits
Luminaires
Volts
Amps
100
Switches
Receptacles
Appliances
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Use/Nature of S"FR/City rehab / Provide GFCI protection in basement, and-install new light and switch"on front orhome~'*check#42i6----"
Work
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Fees: Valuation $468.00
Issued By: ~~
Plan Approval $0.00
Permit Fee Paid $25.00
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Date 11/27/2007
O_~_~~j!."'9.i9~.9J
Parcelld # 0402730000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvalS before starting such activity.
Sign~ure D~e
Agent/Owner
Address
~I~Q_QhE:NBBQQ-'~J:t-.I_-"___-"--_" Q~HKg~.!:L___IJI{L?~~.9j_ - ~?.1L_ Telephone Number ~'?Q.L~1.Q~~~~Q.____" ...
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1~30
Phone'(920) 236-5050
Fax (920) 236-5084
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OJHKOfH
ON THF WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be proce$Sed.
· 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
nonnal permit fee, which ever is greater.
OR
[fvou are a contractor particivatinr in the Permit Fee Account System and have adeQuate funds. check here
ifvou want this vrocessed throuf!h your account 0 .
DATEI/ -.2&.:0 7
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JOBADDRESS ..0
i11"T V e ()V Dn!
OWNER.
,
. CO~CTOR 0 'Ltit 1, +V/ cz Ie f~\'c..
CHECK 6Zf ALL APPLICABLE
USE CATEGORY
,,"Single Family
.SERVICE DNew
DChange
DDuplex
DMulti-Family
DRental DCommercial DIndustrial
TYPE OOverhead.. dJf.l. ot Applicable
OUnderground /.-
DTemporary
DNot Applicable
FllL IN THE APPROPRIATE BLANK WITH THE NUMBER
. Volts /7 0 f 2 <{ 0
:phase I
. !\mps I () {)
Receptacles #
Circuits #
Fixtures # I
Switches #
CHECK 6Zf ALL APPLICABLE
ORange
DFan OR Blower
OMotors
ODishwasher
OFumace
OGas Pumps
DGarbage Disposal
DAlC
OOther
DDryer OWater Heater
DElectric Sign .
DESCRIPTION OF ALL WORK
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~V; It tYtt, L
tWO
,'VALUE(Includinglaborand aIlmaterialsi ludinglightfixtures) $ 163..&(1
MASTER ELECTRICIAN
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Pe/e-.- 2- 0 Cl~
3/02