HomeMy WebLinkAbout2011-Electric (remove knob & tube wiring in attic) / CITY OF OSHKOSH No 144761
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1307 WASHINGTON AVE Owner SHAHNAZ SHAKIBAIAN Create Date 01/27/2011
Contractor ACTION ELECTRIC, ELECTRICAL CON1 Category 612 - Residential - Single Family Addition /R Plan
Service 0 New «) Change 0 Temp • N/A Type O Overhead Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
Use /Nature of SFR\ Remove K & T in the attic
Work
Fees: Valuation $1,400.00 Plan Approval $0.00 Permit Fee Paid $77.00
Issued By: 4 Date 01/27/2011
❑ Permit Voided Parcel Id # 0203640000
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 applica ithin an ement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure an ne ary pr Is before starting such activity. /^
Signature Date -;:.)
Agent/Owner
Address W1906 COUNTY ROAD JJ KAUKAUNA WI 54130 - 9417 Telephone Number (920) 788 -4020
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
41
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236-5084 OJHKOJH
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 7` c) 7 / 7 '
JOB ADDRESS / 3° ? L./ 0-cki n 5
OWNER &4J4) cA
CONTRACTOR u r- f G L
CHECK la ALL APPLICABLE
USE CATEGORY
[Mingle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # Circuits #
Phase
Amps Switches # Fixtures #
CHECK la ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal DDryer DWater Heater
[Wan OR Blower ❑Furnace DA/C DElectric Sign
❑Motors ❑Gas Pumps ❑Other J J
DESCRIPTION OF ALL WORK BEING DONE � o�` - 9 " fie /h AWAL
VALUE (Including labor and all materials including light fixtures) $ I (' °
MASTER ELECTRICIAN ,70.1 6 7
3/02