HomeMy WebLinkAbout0130783-Electric (service panel)CITY OF OSHKOSH No 130783
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 506 W 19TH AVE Owner MATTHEW D LOWTHER Create Date 06/20/2008
Contractor VAN ERT ELECTRIC CO INC Category 634 -Residential-Service Change Plan
Service New ~ Change ~ Temp ~ N/A Type ~ Overhead 0 Underground
Volts 120 / 240 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
Use/Nature of
Work
/RELOCATE
Fees: Valuation
C
Issued By: ~
Plan Approval $0.00 Permit Fee Paid $39.00
^ Permit Voided
Date 06/20/2008
Parcel Id # 1407390000
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 2000 PROGRESS WAY KAUKUANA WI 54130 - 9562 Telephone Number 920-766-3888 462-14;
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 Inspecdon Services
P.O. Box 1130
Oshkosh, WI 54903-1 1 30
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVE
JOB ADDRESS ~~(Q w• ~~ `~
ELECTRICAL PERMIT APRI~iIQrA-~j~N
HK H
ON THE WATER
All information after bold categon~'es~~~6EV~VT OF
Incomplete applications wil ELOPMENT
INSPECTION SERVICES DIVISION
• Applications} 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
normal permit fee, which ever is greater.
OR
!f you are a contractor Darticinating in the Permit Fee AccounrSvstem and have adequate funds check h,
rf you want this processed throu~vour account ^
DATE ~~/~~
OWNER ~~ ~
CONTRACTOR ~ ~'Z1-~ZZZ
CHECK B! ALL APPLICABLE
~SE CATEGORY
Single Family Duplex
SERVICE ^New ^Temp
^Ghange. ^Not A
FILL IN THE APPROPRIATE
Volts ~• ~ ~ l a-4~
Phase 1
Amps -~~
CHECK B! ALL APPLICABLE
^Iviulti-Family ^Rental ^Commercial ^Industrial
orary TYPE ^Overhead ^Not Applicable
pplicable ^Underground
BLANK WITH THE NUMBER
Receptacles # Clrcults #
Switches # ~ Ffixtures #
^Range ^Dishwasher ^Garbage Disposal ^Dryer ^Water Heater
CJFan OR Blower ^Furnace ^A/C ^Electric Sign
[7Motors ^Gas Pumps ^Other
DESCRIPTION OF ALL WORK BEING DONE ~~Yt (~ I~;C
VALUE (Including tabor and all materials including light fixtures) $ ~~_ ~
MASTER ELECTRICIAN c
~~
~ ~~b~---~, 1~.e~rrn~~ ~.~.,Q ~~ 6~
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