HomeMy WebLinkAbout0145571-Electric CITY OF OSHKOSH No 145571
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 609 GROVE ST Owner DONALD D /BRENDA L WILSON Create Date 04/21/2011
Contractor HOMEOWNER Category 612 - Residential - Single Family Addition /R Plan
Service 0 New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches 2 Receptacles 3
Appliances Bath fan in new 1/2 bath and relocate dishwasher.
Use /Nature of Interior remodel to include drywall repair, wood work, carpet replacement, new closet, half bath on the 1st floor. Wall covering will be
Work new drywall over existing plaster walls.
Fees: Valuation $350.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: Date 4/21/2011
El Permit Voided Parcel Id # 1104010000
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 perfomi the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) d to secyre anyrn ss ry approvals before starting such activity.
Si t e //�• /J,l� Date
Agent/Owner
Address DONALD D /BRENDA L WILSON MENASHA WI 5495 - 1033 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 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
ifyou want this processed through your account ❑
DATE `l
JOB ADDRESS (6 q ► � T 3c(
OWNER le y I
CONTRACTOR ' ✓y IL
CHECK CHECK H ALL APPLICABLE
USE CATEGORY
It Single Family ❑Duplex ❑Multi - Family ❑Rental El Commercial [Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts at. Receptacles # 3 Circuits #
Phase
Amps 1aci: Switches # 2 Fixtures #
CHECK H ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer El Water Heater
[Nan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑ Other
DESCRIPTION OF ALL WORK BEING DONE azYlck &
s �hik -g t /I,
Ad a v1/24 M rye_ s0 l)1( / i� � a, CX�: ,i
VALUE (Including labor and all materials including light fixtures) $ 3
MASTER ELECTRICIAN
3/02
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