HomeMy WebLinkAbout0141766-Electric CITY OF OSHKOSH No 141766
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1376 W SOUTH PARK AVE Owner STEVEN J /MONIQUE M MUELLER Create Date 06/29/2010
Contractor HOMEOWNER Category 612 - Residential - Single Family Addition /R Plan
Service 0 New 0 Change 0 Temp 0 N/A Type 0 Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
Use /Nature of SFR/ Remodeling the bathroom. Gutting the room and installing new insulation, drywall and flooring. An exhaust fan will be installed for
Work ventilation.
Fees: Valuation $450.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: \ Date 6/29/2010
El Permit Voided 1 Parcel Id # 1307280100
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 Date
Agent/Owner
Address OSHKOSH WI 5490 - 0000 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 RECEIVE
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050 JUN 8 2010
Fax (920) 236 -5084 DEPARTMENT OF � JH K OJH
COMMUNITY DEVELOPMEN ON THE WATER
ELECTRICAL PERMIT AfilEntAffitffi DIVISION
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 ❑
DATE Le I'M) )10
JOB ADDRESS IJ' 557,071 -Parr k #v{„ / (Y-A704,„
OWNER rnon,a-. S4tV41 (it Cite
CONTRACTOR SQ 1.'
CHECK El ALL APPLICABLE
USE CATEGORY
%Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not lid:Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # Circ its #
Phase
Amps Switches # Fixt res #
CHECK VI ALL APPLICABLE
❑age ❑Dishwasher ❑Garbage Disposal ❑D er ❑Water Heater
,Van OR Blower ❑Furnace ❑A/C ❑E1: ctric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE ', � / , c- 1 / 6 ' r/ . � 'Ace u
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN
3/02