HomeMy WebLinkAbout0151753 -Electric (svc repairs due to storm) 0 CITY OF OSHKOSH No 151753
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1414 CATHERINE AVE
Owner ROBERT J DUSHENSKI Create Date 07/06/2012
Category Contractor PJ ELECTRICAL SERVICES LLC 9 rY 634-Residential-Service Change Plan
Inspector Adam Krause
Service 0 New • Change 0 Temp
N/A 1 Type • Overhead 0 Underground
Volts 120/240
Circuits Luminaires
Amps 100
Switches Receptacles
Appliances
Use/Nature of SFR 1 Service repairs due to storm damage. **check#1014
Work
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $25.00
� � Date 08/16/2012
Issued By: (T' i � y"'�"
[] Permit Voided I Parcel Id# 1601090000
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. Date
Signature
Agent/Owner
Address 6074 GREEN VALLEY RD
OSHKOSH WI 54904 -9751 Telephone Number (920)410-2464
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address,Permit e andyphof
Inspection(i.e.Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),y our Nam
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 oOofInsh
Division ision of Inspection Services
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050 O.lHKOf H
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 11 aSt �ol }`
JOB ADDRESS / L/1 N Cam.f h t r. At/e_
OWNER Ito e 1) u lvl e
pp ck
CONTRACTOR P. 3. L"---/i t je.c a I See✓i c<S LL L.
CHECK El ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ®Overhead ❑Not Applicable
NChange DNot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts i a o / 3 Li 0 Receptacles# Circuits#
Phase 1
Amps I coo Switches# Fixtures#
CHECK Lf ALL APPLICABLE
ORange DDishwasher ❑Garbage Disposal DDryer ❑Water Heater
❑Fan OR Blower ❑Furnace DA/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other /
DESCRIPTION OF ALL WORK BEING DONE S-1-o o g 0_ c. -4-13
sc. ,t_. IZef ,iecI 40 0.4-' potjt-- 6o, k Ov
VALUE (Including labor and all materials including light fixtures) $ c00,0 U
MASTER ELECTRICIAN Pe_ It Oa dew
3/02