HomeMy WebLinkAbout0138248-Electric (garage)0 CITY OF OSHKOSH No 138248
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1421 W NEW YORK AVE Owner STANLEY W /MARY KOTSCHI Create Date 09/22/2009
Contractor HOMEOWNER Category 610--, Residential -New Single Family Servi Plan
Service New Change Temp 0 NIA 1, Type 0 -- Overhead Underground
Volts 120/240 Circuits 8 Luminaires 10
Amps 50 Switches 5 Receptacles 12
Appliances
Use /Nature of SFR\ UG Subfeed to garage and associated wiring.
Work
i
Fees: Val
Issued By:
$1,000.00 Plan Approval $0.00 Permit Fee Paid $60.00
Permit Voided
Date 9/22/2009
Parcel Id # 0506570200
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 secure any necessary approvals before starting such activity.
Signature J— > Date
Agent/Owner
Address OSHKOSH WI 5490- 2712 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.
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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 System and have adequate funds, check here
if you want this processed through vour account ❑
JOB ADDRESS 1'4 2- ( w (jF=w yiZK
OWNER S ^J loo
CONTRACTOR QT-" �' l��-z-s
CHECK 0 ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi - Family
SERVI-- ❑Temporary
❑Change -43" Applicable
DATE q - zz. - :,q
❑Rental ❑Commercial ❑Industrial
TYPE ❑Overhead ❑Not Applicable
Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / t- e / L4 0 Receptacles # Circuits #
Phase 1
Amps - Switches # `% Fixtures # Z'
Z
CHECK 0 ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE EL e ` rn � � S'�` t ,) j T-° r`t & v j A 2
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN .k — ', -5 li�
if
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