HomeMy WebLinkAbout0152194 - Electric (chg service) CITY OF OSHKOSH No 152194
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 612 ELMWOOD AVE
— — Owner MICHAEL J LYSTER Create Date 09/07/2012
Contractor ENTERPRISE ELECTRIC INC
- - Category 634-Residential-Service Change Plan
Inspector Adam Krause
Service 0 New • Change -- -
0 Temp N/A
� _ Type ❑ Overhead • Underground
Volts 120/240
Circuits
Luminaires
Amps 100 Switches
Appliances Receptacles
Use/Nature of SFR/CHANGE EXISTING SERVICE TO UNDERGROUND UWO,ALL INTERIOR TO STAY AS IS **check#3438
Work
I _
Fees: Valuation U50.00 Plan Approval $0.00
Permit Fee Paid $53.00
Issued By:
Date 09/07/2012
❑ Permit Voided Parcel Id# 0702960000
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 1039 DRIESSEN CT — KAUKAUNA WI 54130 - 1105
— -- — Telephone Number (920)766-1995
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 OJHKO..IH
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$100.00 plus the
normal permit fee,which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account ❑
DATE CI I 5 12
JOB ADDRESS 6 i q CI ny 0004
p 47:rt
OWNER rn%kr,. Li Dir la , t4i
CONTRACTOR Cn'ker? :' ck:■r-N 7,1rt( SEP 07 2012
CHECK l ALL APPLICABLE DEPA R TMENT DE,; OF
COMMUNITY, DEVz_L<<.,;,,,E NT
USE CATEGORY I;NSPEC.Ti" ..._
G�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE DOverhead ❑Not Applicable
LAChange ❑Not Applicable C'Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts /A) /c2LD Receptacles# Circuits#
Phase 1
Amps � 'c /00 Switches# Fixtures#
CHECK 8 ALL APPLICABLE
ORange ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE Ck,\cAvoe ee'k!4:Po A Ce 40 Ufrf-CO Vrx , (,X,AjO
f1` Ivy tf'rtr - -io ; ray cx,f3 !.S
32
VALUE(Including labor and all materials including light fixtures)$ SAY?
MASTER ELECTRICIAN -RAJ
3/02