HomeMy WebLinkAbout0151404 - Electric -Add new wiring , switches) CITY OF OSHKOSH No 151404
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1471 WHEATFIELD WAY Owner JEFFREY M/AMY A LACOSSE Create Date 07/27/2012
Contractor HOMEOWNER Category 623-Residential-Duplex Addition/RemodE Plan
Inspector Adam Krause
Service 0 New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits 4 Luminaires 1
Amps 100 Switches 1 Receptacles 4
Appliances
Use/Nature of Remove 220 supply for dryer(converted to gas). Adding 2 20amp AFC!breakers. Adding new wiring,switches and outlets for storage
Work -re and fridge.
Fees: Valuation 00 Plan Approval $0.00 Permit Fee Paid $32.00
Issued By: ,,. _ Date 7/27/2012
El Permit Voided Parcel Id# 1341020000
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 perforrp said ork.
In the performance of this work I a ree to perform all work pursuant to rules governing the described construction.
While the-City of.Oshko h has n aut rity to enforce easement restrictions of which it is not a party, if you perform the work
described in thin permit plicati fi wif in an easement,the City strongly urges the permit applicant to contact the easement
h na(ur td secure any a ssq'ry p ovals before starting such activity.
holder(s,�and /
., ' / Date (�4I Z,?-/ Z
Agent/Owner
Address OSHKOSH WI 5490- 7423 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 O�I I�O�I I
Fax (920)236-5084
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 D}tv—(iZ
JOB ADDRESS 4.1 u>>'`124 Q.A.c
OWNER L Lr e
CONTRACTOR Cq".
CHECK Q ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE DOverhead ❑Not Applicable
''Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# `T Circuits# 4
Phase
Amps * 100 Switches# \ Fixtures#
CHECK l3 ALL APPLICABLE
O Range ❑Dishwasher ❑Garbage Disposal , Dryer ❑Water Heater
D Fan OR Blower ❑Furnace ❑A/C DElectric Sign
❑Motors ❑Gas Pumps tOther re1c,
DESCRIPTION OF ALL WORK BEING DONE
Gila it _ bo 1S 1( S_ �ek�
A ,-.( ✓,c ex t5 ir; 30 F\vulp (2 1-0) i l.,v.„ci-' �– Acc T,vetL2 r>
RD 01—ir v ` - jY ` ;✓; e clue I(e.�C .V)(ht C r
VALUE (Including labor and all materials including light fixtures) $ LOO.
MASTER ELECTRICIAN
3/02
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