HomeMy WebLinkAbout2007-Electric
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OSHKOSH
ON THE WATER
Job Address 1102 ADAMS AVE
Contractor QUALITY ELECTRIC
CITY OF OSHKOSH
No
128150
ELECTRIC PERMIT - APPLICATION AND RECORD
Service
o New
120/240
o Change
Owner KERRY DERR Create Date 11/12/2007
Category 612 - Residential-Single Family Addition/R Plan
o Temp . N/A Type o Overhead o Underground
Circuits Luminaires
Switches Receptacles 3
Volts
Amps
100
Appliances
Use/Nature of SFR I City rehab / Provide GFCI protection where needed per code, three new ouUets in basement, vent fan in bath, and wire furnace.
Work
Fees: Valuation
$950.00
Plan Approval
$0.00
Permit Fee Paid
$60.00
Issued By:
~A~
~
Date 12/12/2007
o Permit Voided I
Parcel Id # 1605580000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address
3750 GLEN BROOK LN
OSHKOSH
WI 54904 - 8517
Telephone Number (920) 410-5890
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1~30
Phone"(920) 236-5050
Fax (920) 236-5084
~
OJHKOfH
ON THf WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be proce$Sed.
. Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oslikosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
.nonnal pennit fee, which ever is greater.
OR
[(vou are a contractor particivatinr:. in the Permit Fee Account System and have adeouate funds. check here
ifvou want this vrocessed throu1!h vou;. account D. "
" DATE /2-/2~o7
JOB ADDRESS I/o 2 f1dfttY\5 sfr.
OWNER " f( e f"M1 f) er t'
Q~\~.\r Z/.ecio~~
CONTRACTOR
CHECK Ia ALL APPLICABLE
USE CATEGORY
tgtSingle Family
ODuplex
OMulti-Family
ORental o Commercial o Industrial
TYPE OOverhead ,Wt'Not Applicable
DUnderground
."SERVICE DNew
DChange
DTemporary
DNot Applicable
" FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
. Volts /24 I 2tfo
~hase I
. Amps lIS e.
Receptacles # 3
Circuits #
FixtUres #
I
Switches #
CHECK Ia ALL APPLICABLE
ORange DDishwasher DGarbage Disposal ODryer DWater Heater
OFan OR Blower DFumace DAlC OElectric Sign "
OMotors OGas Pumps o Other _
D~ONOFALLWORKBElNGDONE City {,thf}hl. iYFl (IV }~p.M~ tl/.f{t
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MASTER ELECTRICIAN
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