HomeMy WebLinkAbout0134098-ElectricCITY OF OSHKOSH No 134098
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3135 HALLIE HOLLOW CT Owner THEODORE A/PAMELA K MILLER Create Date 11/19/2008
Contractor HOMEOWNER Category 612 -Residential-Single Family Addition/R Plan
--
Service New ~ Change (~ Temp ~ N/A Type Q Overhead 0 Underground
Volts Circuits Luminaires 2
Amps Switches 2 Receptacles 2
Appliances
Use/Nature of
Work
recept., varnty, wall
Fees: Valuation $300.00 Plan Approval $0.00 Permit Fee Paid $25.00 __
Issued By: _J/~~~~_- Date 11/19/2008
Permit Voided
Parcelld # 1343680000
The undersigned, in applying for an Electric Permit to perform electrical work within a single family home, owned and occupied
as the principle residence by the undersigned, hereby acknowledges per City Municipal Code Section 11-22, that other
individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the
City of Oshkosh to perform said work.
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 se ny necessary ovals before starting such activity. 4
Signature ~-~ ~. A ~'~ _ Date 1 ~~~ \ ~~
Address
Agent/Owner
OSHKOSH WI 5490 - 6302 Telephone Number
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.
O HKOlH
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 barticipating in the Permit Fee Account System and have adequate funds check here
if you want this processed through your account ^ G
,1 \ ` \ DATE \\ ~ Q 0
JOB ADDRESS ~ \3,S ~b.~~ft ~- t'~~ 1111'y~j C~
OWNER ~~e~ n~\•.1~ e,f
CONTRACTOR / ~ W hn. ~(
G'
CHECK E1 ALL APPLICABLE
USE CATEGORY
'~1Single Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial
SERVICE ^New ^Temporary TYPE ^Overhead ^Not Applicable
^Change ^Not Applicable ^Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts ~ ~ ~ / Receptacles # ~ Circuits #
Phase
Amps
CHECK El ALL APPLICABLE
^Range ^Dishwasher
~'an OR Blower ^Furnace
^Motors ^Gas Pumps
OF ALL
Ufk~
Switches # ~
^Garbage Disposal
^A/C
^ Other
1\
Fixtures #
^Dryer ^Water Heater
^Electric Sign
~~ ~a~
VALUE (Including labor and all materials in~clu~d~i light fixtures) $ ~~ ~ ~ ~ ~
MASTER ELECTRICLAN
3/02