HomeMy WebLinkAbout0146614-Electric (receptacle & fixture) CITY OF OSHKOSH No 146614
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1119 BUCHANAN AVE Owner LAWRENCE E /LORRAINE HERGERT Create Date 06/29/2011
Contractor WITZKE ELECTRIC INC Category 612 - Residential - Single Family Addition /R Plan
Inspector Adam Krause
Service O New O Change O Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits
Luminaires
Amps Switches Receptacles
Appliances
Use /Nature of !SFR / DRYER RECEPTACLE. AND CLOSET FIXTURE **debit acct
Work
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: ?3 Y 1l Date 06/29/2011
❑ Permit Voided Parcel Id # 1604880000
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 PO BOX 102 OSHKOSH WI 54903 - 102 Telephone Number (920) 235 -6572
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.
JUN.29.2011 3 :15PM WITZKE ELECTRIC N0. 154 P.1/1
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130 Phone (920) 2364050
Fax (920) 236 -5084
ELECTRICAL PERMIT APPLICATION " THE w TER
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
Oshkosh WI '54903 -1128. Comrriencing work without permit(s) will result in fees being doubled or 5100 .00 plus the
normal permit fee, which ever is Box 1 128,
,
OR
greater
Q s o s to h c n ,av_ •d_,u, a d_ , k ie
JOB ADDRESS DATE /
OWNER LCl.wr ence., Akir er
CONTRACTOR ( .G.,_
•
CHECK el ALL APPLICABLE
E CATEGORY
Single Family °Duplex ClMulti -Family DRcntal
SERVICE phew ❑Commercial • ❑Industrial
gTemporary TYPE °Overhead
❑Change °Not Applicable C1Not Applicable
❑Underground
FILL IN THE APPROPRIATE BLANK WITH TEE DER . . •
Volts
Phase Receptacles # Circuits #
Amps
Switches #
Fixtures # .
CFIECI{ MALL APPLICABLE
❑Range ❑Aishwasher
°Garbage Disposal ODryer Water Heater
°Fan OR Blower PFumace
❑Motors C]Gas Pum s DAIC QElectrio Sign
P Other
DESCRIPTION OF ALL WORK BEING DONE g '
VALUE (Including labor and an materials including light ght fixtures) S__ ,rte •
_______I:) , Ltin:l...._ ( ... Q .,______________L,
MASTER ELECTRICI
t /.4fra:Ieei Received Time Jun, 29. 2011 3:12PM No. 6191
A5(00
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