HomeMy WebLinkAbout0145726-Electric CITY OF OSHKOSH No 145726
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3710 WESTERN CT Owner MATTHEW D /LISA R HAUCK Create Date 05/03/2011
Contractor HOMEOWNER Category 611 - Residential -New Single Family Wirin Plan
Inspector Adam Krause
Service 0 New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches 3 Receptacles 20
Appliances
Use /Nature of Install electrical work for family room and adjacent room only. Does not include wiring for future Storage room, laundry room, and
Work bathroom.
Fees: Valuation / $600.00 Plan Approval $0.00 Permit Fee Paid $32.00
A
Issued B ,.10e Date 5/3/2011
E Permit Voided Parcel Id # 1261170000
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 to secu y ne - sary approvals before starting such activity.
Signature res ter _ Date
s Agent/Owner
Address OSHKOSH WI 5490 - 1196 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 Of HKOJH
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 G J :2 -/(
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JOB ADDRESS � _/ I O as fern b1
OWNER e0/07/ /he /SI¢ �auCk
CONTRACTOR th u, - f M 4
CHECK IZI ALL APPLICABLE
USE CATEGORY
piSingle Family ❑Duplex ❑Multi Family ❑Rental ❑Commercial ❑Industrial
SERVICE gS1New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # Circuits #
Phase
Amps Switches # 3 Fixtures # 20
CHECK la ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal DDryer DWater Heater
❑Fan OR Blower DFurnace DA/C DElectric Sign
❑Motors ❑Gas Pumps ❑ Other wet i / nt..tdlatt Swi f c
DESCRIPTION OF ALL WORK BEING DONE_
r►/ I-V Rocrt Ate- . pive y
POA5 — �IJGGvtI� �TuS�G� E RCD/'1 , is,4,IiteRV Rerei, 3kTJ-nkefv"
VALUE (Including labor and all materials including light fixtures) $ 60
MASTER ELECTRICIAN
3/02