HomeMy WebLinkAbout0146190-Electric CITY OF OSHKOSH No 146190
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 910 W NEW YORK AVE Owner MATTHEW R/KANDACE D WILSON Create Date 06/03/2011
Contractor HOMEOWNER Category 612 - Residential - Single Family Addition /R Plan
Inspector Adam Krause
Service 0 New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits 2 Luminaires 4
Amps Switches 2 Receptacles 5
Appliances Fan, steam shower, in -floor heat
Use /Nature of SFR\ Remodeling former upper unit space to create a bigger bathroom and a walk -in closet. Remove 2nd meter from service and
Work back -feed upper unit panel.
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $77.00
Issued By: Date 6/3/2011
Permit Voided Parcel Id # 1204090000
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 secure any nece sary approvals before starting such activity.
� Signature 4 Date 3 - 7 M" f
Agent/Owner
Address OSHKOSH WI 5490 - 3642 Telephone Number Matt work # 751 -561
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 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 contractorparticipatingin the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account ❑
DATE 3 7 w 6 .- - 201(
JOB ADDRESS q 1p 1.0 NEA.J YoRA& AVE.
OWNER MA +- kR^t01 w1L,So
CONTRACTOR
CHECK f1 ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable DUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # 5 Circuits # Z
Phase
Amps Switches # 2 - Fixtures # 4
CHECK 13 ALL APPLICABLE
D Range DDishwasher ❑Garbage Disposal DDryer DWater Heater
❑Fan OR Blower DFurnace ❑A/C DElectric Sign
❑ Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE 8A-n4 Roane Rs..A-00 (a. -ro IWeLvD€ /V00I p °ABM.
6F-c1 trr tfit / IM- fti40tZ KE_A? (. - rt AA/D Vrw'r .Arl on) FA-iv. Com INC (d1' &
Aw9 L D-vcrA 91. SJ1tVict. -ro Su/G (co urh - ri S@u"1
STE4M SA-Di-42 04420 445 Girceihti cM.
VALUE (Including labor and all materials including light fixtures) $ 2 090
MASTER ELECTRICIAN %
3/02