HomeMy WebLinkAbout0147143-Electric CITY OF OSHKOSH No 147143
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1233 CEAPE AVE Owner RANDALL J /ROXANNE R SULTZE Create Date 08/08/2011
Contractor HOMEOWNER Category 612 - Residential - Single Family Addition /R Plan
Inspector
Service 0 New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
Use /Nature of SFR/ Rewiring the house* the walls and ceilings have been gutted.
Work
Fees: Valuation $1,000.00 Plan Approval $0.00 Permit Fee Paid $60.00
Issued By: CIFT Date 8/8/2011
Permit Voided Parcel Id # 0804760000
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 necessary approvals before starting such activity.
Signature �C /Qp, ,,, �i,�` Date )
�"` Agent/Owner
Address OSHKOSH WI 5490 - 0000 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
ifyou want this processed through your account ❑
DATE ^7 //
JOB ADDRESS /o? , Q c
OWNER R19ii €r4L L J S v /Tc C
CONTRACTOR
CHECK ® ALL APPLICABLE
USE CATEGORY
PiSingle 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 # Circuits #
Phase
Amps Switches # Fixtures #
CHECK Fli ALL APPLICABLE
❑ Range ❑Dishwasher ❑Garbage Disposal DDryer ❑Water Heater
❑ Fan OR Blower ❑Furnace DA/C DElectric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE Re Q \okce w)
new Gait 1'41
VALUE (Including labor and all materials including light fixtures) $ MCC)
MASTER ELECTRICIAN
3/02