HomeMy WebLinkAbout0132567-Electric (misc.)CITY OF OSHKOSH No 132567
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 206-212 W 12TH AVE Owner DALE M/SHERRY L HOTOVEC Create Date 08/28/2008
Contractor GROVER ELECTRIC Category 643 -Commercial-Addition/Remodels Plan
Service New ~ Change ~ Temp ~ N/A Type ~ Overhead (~ Underground
Volts 120 / 208 Circuits Luminaires
Amps Switches Receptacles
Appliances
Use/Nature of OMM (212 -ENERGY SERVICES) /ADDING RECEPTACLES AND MOVING LIGHT FIXTURES
Work
Fees: Valuation $1,125.00 Plan Approval $0.00 Permit Fee Paid $77.00
Issued By: ~ Date 08/28/2008
^ Permit Voided Parcel Id # 0901240000
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 a any essa approv b re starting such activity.
Signature Date ~-2~-L~
AgenUOwner
Address 1650 S OAKWOOD RD OSHKOSH WI 54904 - 8347 Telephone Number (920) 379-7259
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 54903-1130
Phone (920)236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
L
ofHKOfH
ON THE WATER
~ 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 you are a contractor participating in the Permit Fee Account Svstem and have adequate funds check here
zf you want this processed throu~your account ^
DATE ~ -~- ~"~~
q
JOB ADDRESS/ ~ '
OWNER
CONTRACTOR~~~ ~-/ ~ (-e < <,,
~-
CHECK H ALL APPLICABLE
USE CATEGORY
^Single Family ^Duplex ^Multi-Family
SERVICE ^New ^Temporary
^Change Not Applicable
^Rental commercial ^Industrial
TYPE ^Overhead ^Not Applicable
^Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts ~~ / 20~ Receptacles #
Phase '3
Amps Switches #
CHECK H ALL APPLICABLE
^Range ^Dishwasher ^Garbage Disposal
^Fan OR Blower ^Furnace ^A/C
^Motors ^Gas Pumps ^Other
Circuits #
Fixtures #
^Dryer ^Water Heater
^Electric Sign
DESCRIPTION OF ALL WORK BEING DONE ~~c.+' i ~ /I ~r ~ ~~h~'(~ ~-
VALUE (Including labor and all materials including light fixtures) $ ~
MASTER ELECTRICIAN (~~./'
3/02