HomeMy WebLinkAbout0143490-Electric (misc. interior) CITY OF OSHKOSH No 143490
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 529 WAUGOO AVE Owner KELLY R/LISA M ASCHEBROOK Create Date 10/07/2010
Contractor DREXLER ELECTRIC 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 1
Amps Switches 1 Receptacles 1
Appliances
Use /Nature of SFR / Replace receptacle, add switch and light fixture.
Work
Fees: Valuation $400.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: A-31/22 Date 10/07/2010
❑ Permit Voided Parcel Id # 0202220000
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 OJHKO.H
ON THE WATER
4 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 eiv adequate funds, check here
if you want this processed through your account ❑
DATE /0 1 7 1— t D
JOB ADDRESS Jq OD /Ln.e
OWNER � ive_w ! ✓�
CONTRACTOR 2 EZG r7nic
CHECK ® ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex ❑Multi- Family OIRental DGomfinercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead 17Not Applicable
❑Change pNot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts /2 / Receptacles # / Circuits #
Phase /
Amps /S Switches # / Fixtures #
CHECK El ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
DMotors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE 7 C ce / c c (c if n'V2
A O nl-L J "w 4,4
r Ft`..:
VALUE (Including labor and all materials including light fixtures) $ .4/00 e
OCT 6 2010
MASTER ELECTRICIAN 1Z-04 Q �J
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