HomeMy WebLinkAbout0151881 - Electric (bdrm remodel) CITY OF OSHKOSH No 151881
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 651 W 11TH AVE Owner DEVEN D ADAMS/SAMANTHA L WILD Create Date 08/22/2012
Contractor HOMEOWNER Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service O New O Change O Temp • N/A Type 0 Overhead O Underground
Volts Circuits Luminaires 1
Amps Switches 3 Receptacles 4
Appliances
Use/Nature of SFR/Install wiring for bedroom remodel. Installation shall comply with State and local electrical codes.
Work
Fees: Valuation $300.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: Date 8/22/2012
Permit Voided ; Parcel Id# 1303740000
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 se re any necessaarryy approvals b;ore start' g such activity.
Signatu I' / / -/ -_ i ` Date ,47 I
Agent/Owner
Address OSHKOSH WI 5490- 6309 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 OJHKOf H
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 adequ to funds, check here
if you want this processed through your account ❑
DATE q J14
JOB ADDRESS S t \7■7 V t(vi
OWNER Dk vq) A d 5/.7 jet t t;4 d0
CONTRACTOR
CHECK Q ALL APPLICABLE
USE CATEGORY
single Family ❑Duplex ❑Multi-Family DRental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE vOverhead ❑Not Applicable
Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase '}
Amps Switches# J Fixtures#
CHECK El ALL APPLICABLE
ORange ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace DA/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE
ALL C1rrr.,st. CzAtis + Cif\ urn OW 44.41\1\y u 014145, MctIAq
rlitArt &nA 0,„e_ nC'1.- s„ ;It1\
VALUE (Including labor and all materials including light fixtures) $ ILO -CV
MASTER ELECTRICIAN
lD 8 3 3/02