HomeMy WebLinkAbout0139886-Electric CITY OF OSHKOSH No 139886
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 826 W 6TH AVE Owner ROBERT C /LAURIE A MALLIETT Create Date 02/26/2010
Contractor HOMEOWNER Category 612 - Residential - Single Family Addition /R Plan
Service 0 New O Change O Temp • N/A Type O Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches - Receptacles
Appliances
-
Use /Nature of SFR\ Bath remodel
Work
Fees: Valuation //�� $600.00 Plan Approval $0.00 Permit Fee Paid $32.00_ _
Issued By: Gt Date 2/26/2010
n Permit Voided Parcel Id # 0604240000
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 ua necessary approvals before st ting such activity.
Signature �(4 c G � Date
Agent/Owner
Address OSHKOSH WI 5490 - 5849 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
Oshkosh, WI WI 54903-1130
4
Phone (920) 236 -5050
Fax (920) 236-5084 OHKOJH
ON THE WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
• 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
Ifyou are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account ❑ 1 +
DATE G�— I C' __ 2 / C
JOB ADDRESS g 4_3 4/4
OWNER ia _ e. e— /4 e _
CONTRACTOR S 'e A
CHECK gi ALL APPLICABLE
US„EXATEGORY
Single Family ❑Duplex ❑Multi - Family [Mental ❑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 Switches # Fixtures #
CHECK IN ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer El Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE /( //��
e w & 44 ,era
VALUE (Including labor and all ma ials including light fixtures) $ 6 6 O
MASTER ELECTRICIAN ,�/�
3/02