HomeMy WebLinkAbout0145248-Electric CITY OF OSHKOSH No 145248
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 826 BISMARCK AVE Owner KEVIN L/ELAINE SCHOUTEN Create Date 03/24/2011
Contractor HOMEOWNER Category 612 - Residential - Single Family Addition /R Plan
Service 0 New Change 0 Temp • N/A Type 0 Overhead O Underground
Volts Circuits
Luminaires
Amps Switches Receptacles
Appliances
Use /Nature of SFR\ Adding outlets and ceiling fans to remodel a family room and bedroom. All wiring to meet current code requirements
Work
Fees: Valuation $600.00 Plan Approval $0.00 Permit Fee Paid $32.00
Issued By: - Date 3/24/2011
[ j Permit Voided Parcel Id # 0604960000
The undersigned, in applying for an Electric Permit to perform electrical work within a single family home, owned and:occupied
as the principle residence by the undersigned, hereby acknowledges per City Municipal Code Section 11-22,' that other
individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the
City of Oshkosh to perform said work.
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 t• e• re a nec; ssary approvals before starting such activity.
Signature
Date _____
Agent/Owner
Address OSHKOSH WI 5490 - 5812 Telephone Number
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 OJHKOIH
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 ❑
Q' DATE Q' oZ �/
JOB ADDRESS va - £ /ha6-1 v
OWNER .1/( //t I c(Gtc:7 �c v►
CONTRACTOR 0 (C' Lr 1
CHECK ® ALL APPLICABLE
Rs E CATEGORY
ingle Family ❑Duplex ❑Multi - Family DRental ❑Commercial ❑Industrial
SERVICE ❑New 4 TYPE ❑Overhead Applicable
❑Change Tot *Tot
Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # Circuits #
Phase
Amps Switches # Fixtures #
CHECK BI ALL APPLICABLE
DRange DDishwasher DGarbage Disposal DDryer ❑Water Heater
❑Fan OR Blower ❑Furnace DA/C DElectric Sign
❑Motors ❑Gas Pumps DOther
DESCRIPTION OF ALI, WORK EING DONE 'd/ n. O' v �G 15 '
Cy t", /, U c � `z/1S`
VALUE (Including labor and all ma erials i eluding Light fixtures) $ G: ' D
MASTER ELECTRICIAN '
3/02