HomeMy WebLinkAbout0143428-Electric (service change) el)/ CITY OF OSHKOSH No 143428
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 307 W 15TH AVE Owner DERRICK S ROSENAU Create Date 10/04/2010
Contractor DREXLER ELECTRIC Category 634 - Residential - Service Change Plan
Service 0 New • Change 0 Temp O N/A Type • Overhead 0 Underground
Volts 120/240 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
Use /Nature of SFR\ Service repairs due to C.N.
Work
Fees: Valuation $893.00 Plan Approval $0.00 Permit Fee Paid $53.00
Issued By: aVrK.4 Date 10/04/2010
❑ Permit Voided I Parcel Id # 0904710000
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 490 COUNTY ROAD FF PICKETT WI 54964 - 9513 Telephone Number (920) 589 -6700
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 Of HKOJH
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
If you are a contractor participatins in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account ❑
DATE q 0--
JOB ADDRESS 307 ` l 5 " 4Vevju
OWNER 10 er cl'C / (Q0ceriOt4)
CONTRACTOR ) i'. kC C�/Z OCT L 6C -K_ 4 2010
L) tv iviEN
COi' MUUrry !"/'-7N;
CHECK 0 ALL APPLICABLE INSPECTION SERVICE'!.;
USE CATEGORY
❑ single Family Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE '?verhead ❑Not Applicable
Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts 1 Zca / ,1Yv Receptacles # Circuits #
Phase )-
Amps /BD Switches # Fixtures #
CHECK H ALL APPLICABLE
:Range :Dishwasher DGarbage Disposal DDryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE SeA-vt
C) i v cs kZ+.
VALUE (Including labor and all mater' Is i luding light fi ture $
MASTER ELECTRICIAN
3/02