HomeMy WebLinkAbout0151589 - Electric (chg svc) IED CITY OF OSHKOSH No 151589
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 622 E PARKWAY AVE Owner CODY T ANDERSON/MELINDA L DORN Create Date 08/03/2012
Contractor DIERSEN ELECTRIC LLC Category 634-Residential-Service Change Plan
Inspector Adam Krause
Service 0 New • Change O Temp 0 N/A
Type • Overhead 0 Underground
Volts 120/240 Circuits 30
Luminaires
Amps 100 Switches
Receptacles
Appliances
Use/Nature of !SFR/CHANGE SERVICE FROM 60AMP TO 100AMP **check#2850
Work
Fees: Valuation $800.00 Plan Approval $0.00 Permit Fee Paid $46.00
Issued By: 3y
Date 08/08/2012
❑ Permit Voided Parcel Id# 0405810000
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 6823 OLEN TRAIL WINNECONNE WI 54986 -8621 Telephone Number (920)740-4875
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 OfHKOJH
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 S-I Z--
JOB ADDRESS 6 2-Z �t/4-4J& A (-Q
OWNERC-6 CQ
CONTRACTOR , 2 fa- z_---4 C 4•--.'i--, LLC
CHECK [Z1 ALL APPLICABLE
CATEGORY
Ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPEverhead ❑Not Applicable
?l Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / 2-VO Receptacles# Circuits# U
Phase S°--P
Amps /Orr Switches# Fixtures II
CHECK Et ALL APPLICABLE
ORange ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Otherr C-41-DESCRIPTION OF ALL WORK BEING DONE 6 c ac' .ce7i.A />
70-0 4111 See—0,'C.&
f'')..
VALUE (Including labor and all materials including light -es) $ `- ~� n
MASTER ELECTRICIAN vv ' s
3/02