HomeMy WebLinkAbout0143530-Electric (kitchen remodel) 0 CITY OF OSHKOSH No 143530
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 868 W 19TH AVE Owner MR/MRS GERALD D MADEL Create Date 10/08/2010
Contractor ELECTRICAL CONTRACTING SPECIALI Category 612 - Residential - Single Family Addition /R Plan
Service O New O Change O Temp • N/A Type Q Overhead O Underground
Volts Circuits 4 Luminaires 8
Amps Switches 6 Receptacles 10
Appliances Dishwasher
Use /Nature of 'SFR / KITCHEN REMODEL **check #2937
Work
I I
Fees: Valuation $2,700.00 Plan Approval $0.00 Permit Fee Paid $94.00
Issued By: (5f Date 10/08/2010
❑ Permit Voided Parcel Id # 1412780000
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 PO BOX 42 BERLIN WI 54923 - 42 Telephone Number (920) 428 -7000
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 I
P.O. Box
Oshkosh, WI WI 54903-1130
Phone (920) 236 -5050
Fax (920) 236-5084 OfHKOfH
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 participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account ❑
DATE fo /r3 //a
JOB ADDRESS S (e t„.) . S gt �}Je
OWNER CC-a- 1^^-4
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CONTRACTOR 6 - C3
CHECK IZI ALL APPLICABLE
USE CATEGORY
[Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New El Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # /0 Circuits # /
Phase
Amps Switches # ( Fixtures # g
CHECK 10 ALL APPLICABLE
D Range ®Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑ Fan OR Blower ❑Furnace DA/C DElectric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE K :
VALUE (Including labor and all materials including light fixtures) $ D
MASTER ELECTRICIAN
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3/02