HomeMy WebLinkAbout0147443- Electric (service change)0 CITY OF OSHKOSH No 147443
OSHKOSH
ON THE WATER
Job Address 941 N LARK ST
Contractor LUXURY ELECTRIC LLC
Inspector
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner MATTHEW I JENKINS
Category 634 - Residential -Service Change
Create Date 09/06/2011
Plan
Service New 0 Change O Temp ❑ N/A Type O Overhead O Underground
Volts 120/240 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
Use/Nature of
Work
Fees: Valuation
Issued By:
ano new
$525.00 Plan Approval $0.00
❑ Permit Voided
Permit Fee Paid $32.00
Date 09/06/2011
Parcel Id # 1602530000
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 necessary app efore starting such activity.
Signature Cr/ Date
Agent/Owner
Address 6071 SPRINGBROOK RD OMRO WI 54963 - 8227 Telephone Number (920) 685-6270
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
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
OWO-H
ON THF WATFR
• 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 ❑
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DATE 65g�T
JOB ADDRESS Y)
OWNER 14 017—
CONTRACTOR
CHECK H ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi -Family Mental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
,Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts 42 O /
Phase
Amps `U'9
CHECK 0 ALL APPLICABLE
❑Range ❑Dishwasher
❑Fan OR Blower ❑Furnace
❑Motors ❑Gas Pumps
Receptacles #
Switches #
❑Garbage Disposal
❑A/C
❑Other
Circuits #
Fixtures #
❑Dryer ❑Water Heater
❑Electric Sign
DESCRIPTION OF ALL WORK BEING DONE C - A-4 /,A dint, le-� /*I
VALUE (Including labor and all mate ' s including 1' ht fixtures) $
MASTER ELECTRICIAN
( K �1�y I 3,02