HomeMy WebLinkAbout0144932-Electric (service change) CITY OF OSHKOSH No 144932
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 113 W 22ND AVE Owner CHUCK BONGERT Create Date 02/18/2011
Contractor JOHNSON ELECTRICAL SERVICES Category 634 - Residential- Service Change Plan
Service 0 New • Change 0 Temp N/A Type • Overhead U Underground
Volts 120 / 240 Circuits Luminaires
-
Amps 100 Switches Receptacles
Appliances
Use /Nature of SFR / SERVICE CHANGE FROM DUPLES TO SINGLE 100 AMP SERVICE
Work
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: Date 02/18/2011
Li Permit Voided ! Parcel Id # 1402610000
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 146 DEFOREST DR KAUKAUNA WI 54130 - 4306 Telephone Number (920) 209 -2494
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
4 1/1"
Phone (920) 236 -5050
-- Fax (920) 236 -5084 OJHKOJ H
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 2 -I 7 I(
JOB ADDRESS 1 1 - 2, ''' A -
OWNER Gann; S A r-/
CONTRACTOR CrN n < -irc.)C 4 ; sr. S. /J 4,ai s / & ( A) g(a_c_+T c.
CHECK ALL APPLICABLE ll
U. CATEGORY
S ingle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE goverhead ❑Not Applicable
Change ❑Not Applicable Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts 17 / 2-0 Receptacles # Circuits #
Phase S; NIhv
Amps lbp Switches # Fixtures #
CHECK 10 ALL APPLICABLE
`Range pDishwasher ❑Garbage Disposal . a6 v ryer ❑Water Heater
D Fan OR Blower I5Ournace ❑A/C DElectric Sign
❑ Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE N —
[ A,ip S ery
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN 1o/ 7877
3/02