HomeMy WebLinkAbout0152203 - Electric (service change) 0 CITY OF OSHKOSH No 152203
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 386 N WESTHAVEN DR Owner SALLY HIELSBERG TRUST/CARL TICKS T Create Date 09/07/2012
Contractor MY ELECTRIC CORP Category 634-Residential-Service Change _ Plan
Inspector Adam Krause
Service Q New • Change O Temp O N/A 1 Type O Overhead • Underground
Volts 120/240 Circuits Luminaires
Amps 200 Switches Receptacles
Appliances
Use/Nature of SFR\Service change
Work
Fees: Valuation $600.00 Plan Approval $0.00 Permit Fee Paid $32.00
Issued By: L Date 09/10/2012
E Permit Voided Parcel Id# 1622320100
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 -•- .0:ion within- eases -• -- strongly urges the permit applicant to contact the easement
holder(s)and to ,40 - any neces.a -=•fr-s before starti • such activity.
Signature _ Date
gent/Owner
Address 6012 KOELPIN RD OSHKOSH WI 54902 -9117 Telephone Number (920)231-0707 _
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
Oshkosh, WI WI 54903-1130
CAD'
Phone(920)236-5050
Fax (920)236-5084 ���
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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 9/10/2012
JOB ADDRESS 386 N.Westhaven Dr.
OWNER Sally Hielsbero
CONTRACTOR MY Electric Corp.
CHECK H ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex ®Multi-Family ❑Rental
❑Commercial ❑Industrial
SERVICE ['New ❑Temporary TYPE ❑Overhead ['Not Applicable
ZChange ❑Not Applicable
Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts 120/240 Receptacles #_ Circuits#
Phase 1
Amps 400 Switches# Fixtures #
CHECK 12I ALL APPLICABLE
❑age ❑Dishwasher ❑G bage Disposal ['Dryer ❑Water Heater
['Fan OR Blower ❑Furnace
['Motors ❑Gas Pumps ❑Other ❑Electric Sign
DESCRIPTION OF ALL WORK BEING DONE
Replace damaged S.E. cable
VALUE (Including labor and all materials including light fixtures)$600.00
MASTER ELECTRICIAN
3/02