HomeMy WebLinkAbout0152479 - Electric 10 CITY OF OSHKOSH No 152479
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 134 W 17TH AVE Owner DOMINIC A SHAFFER Create Date 08/24/2012
Contractor HIPKE ELECTRIC LLC Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service 0 New O Change 0 Temp • N/A Type O Overhead E Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
Use/Nature of FR\Remodeling 2nd flr.according to attached site plan.All work shall be according to current code requirements. Sheetrock and
Work inish 3 bedrooms and sitting area.
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: 4---.0 .-
Date 09/19/2012
El Permit Voided Parcel Id# 0305580000
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 p r it application within an easem: t,the City strongly urges the permit applicant to contact the easement
holder(s)and to 'u e any necessary a ova • •-tier starting such activity.
Signature 4 fef./ ) Date
Agent/Owner
Address 3418 WOODHAVEN CT APPLETON WI 54913 -7906 Telephone Number (920)850-1713
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 54903-1130 /
WI
Phone(920)236-5050
Fax (920)236-5084 OJHKOJH
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 ❑ G, /
/-521/ / r/ DATE / - .2C' / Z
JOB ADDRESS v�-' l 7 (4--
OWNER -DO i�'1 /`k� • � �C 42.[/-
CONTRACTOR Ni`? -e /eC/c't, L L G
CHECK 10 ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE DOverhead ❑Not Applicable
❑Change ❑Not Applicable DUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK El ALL APPLICABLE
❑Range DDishwasher ❑Garbage Disposal ryer DWater Heater
❑Fan OR Blower ❑Furnace DA/C DElectric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALI4 WORK BEING DONE_ �
/�! ✓1 t'S F/t,C 44(4 1 -e /Oar' rkte i
VALUE (Including labor and all m ials including light xtures $ J,-404�/ v
MASTER ELECTRICIAN v!%"5
3/02