HomeMy WebLinkAbout0140004-Electric (garage) e l) CITY OF OSHKOSH No 140004
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 426 W 10TH AVE Owner JERRY GLINIECKI /JANE WESTPHAL Create Date 03/10/2010
Contractor MY ELECTRIC CORP Category 612 - Residential - Single Family Addition /R Plan
Service 0 New O Change O Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
Use /Nature of Duplex / Wire garage.
Work
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $77.00
Issued By: (9-477-4-1 Date 03/10/2010
❑ Permit Voided Parcel Id # 0906250000
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 beforgstarting- swop- eetivityr
Signature �- .. ____ ---- - ""'- Date 34
Agent/Owner
Address 1512 RUGBY ST OSHKOSH WI 54902 - 6360 Telephone Number (920) 231 -0707
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 cJI-H \0JT_
C \. T' 17 WATFR
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
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account ❑
DATE3 /1/2010
JOB ADDRESS426 W. 10 Ave.
OWNERJane Westphal and Jerry Gliniecki
CONTRACTORMY Electric Corp.
CHECK 0 ALL APPLICABLE
USE CATEGORY
❑Single Family Duplex ❑Multi Family ❑Rental ❑Commercial ❑Industrial
SERVICE ['New ❑Temporary TYPE ❑Overhead
[Not Applicable
❑Change Blot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # Circuits #
Phase
Amps Switches # Fixtures #
CHECK 0 ALL APPLICABLE
❑Range DDishwasher ❑Garbage Disposal ['Dryer ❑Water Heater
❑Fan OR Blower ['Furnace ❑A/C ['Electric Sign
['Motors ['Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE
Complete rewiring of garage.
VALUE (Including labor and all materials including light fixtures) $2000.00
MASTER ELECTRICIAN
3/02