HomeMy WebLinkAbout0132823-Electric (service change)CITY OF OSHKOSH No 132823
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 420 FULTON AVE Owner DOROTHY REMBLESKE Create Date 09/11/2008
Contractor DRUCKS PLG 8~ HTG CO., INC Category 634 -Residential-Service Change Plan
Service New ~ Change Q Temp Q NIA Type ~ Overhead Q Underground
Volts 120/240 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
. tt
Usa/Nature of FR/ Repair the overhead service drop.
Work
Fees: Valuation $530.00 Plan Approval $0.00 Permit Fee Paid $32.00
Issued By: :~ Date 09/11/2008
Permit Voided
Parcel id # 1004120000
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 a hority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit applicati thin ease nt he City strongly urges the permit applicant to contact the easement
holder(s) and to secure any n s a vats o starting such activity.
Signature Date _ '
Agent/Owner
Address O BOX 355 MENASHA WI 54952 - 355 Telephone Number (920) 722-2642
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.
O1HKO.IH
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
if you want this processed throu~Your account ^
DATE ~ j
JOB
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CONTRACTOR. ~.yL,~ `3
CHECK Lf ALL APPLICABLE
USE CATEGORY
Single Family ^Duplex ^Multi-Family
SERVICE ^New ^Temporary
^Change ^Not Applicable
~ ~f 4.
~~-C~
^Rental ^Commercial ^Industrial
TYPE ~verhead ^Not Applicable
Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER .
Volts ~; ~ / ~~(,~
Phase
Amps
CHECK B ALL APPLICABLE
^Range
^Fan OR Blower
^Motors
DESCRIPTION
^Dishwasher
^Furnace
^Gas Pumps
ALL WORK BEING
~ ~ ...~
VALUE (Including labor and all materia cluding light fixtures) ;1 ;1~
MASTER ELECTRICIAN 7
Receptacles #
Switches #
^Garbage Disposal
^A/C
^ Other
Circuits #
Fixtures #
^Dryer ^Water Heater
^Electric Sign
3/02