HomeMy WebLinkAbout0152808 - Electric (repairs) CITY OF OSHKOSH No 152808
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3740 GLENSHIRE LN Owner BRANDON/RACHEL HARMON Create Date 09/21/2012_
Contractor TOTAL CONTROL INC Category 610-Residential-New Single Family Servi Plan
Inspector Adam Krause
Service 0 New 0 Change O Temp • N/A Type 0 Overhead O Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
Use/Nature of SFR/REPAIRS-ORDERS ISSUED BY CITY OF OSHKOSH **check#1222
Work
Fees: Valuation $225.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: Date 10/05/2012
❑ Permit Voided Parcel Id# 1278400000
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 648 KREUSER RDG COLGATE WI 53017 -9777 Telephone Number (262)844-8571
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 ? B
ELECTRICAL PERMIT APPLICATION FN ~� � R
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
normal permit fee,which ever is greater. Permits)will result in fees being doubled or$100.00 plus the
OR
,(J'you are a contractor varticipatinP in the Permit Few dcrQUntSvstem and have adequate funds, check here
if you want this processed through your account ❑
DATE `0"C ---/Q
JOB ADDRESS ; 7'!G 6.ler7 S 4/4.e._ 1-n ash 4 peal
OWNER AmnDah
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CONTRACTOR T°11:11 CO/7 I
CHECK®ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex °Multi-Family °Rental
Y ❑Commercial ❑Industrial
SERVICE [New ['Temporary TYPE ❑Overhead
❑Change ❑Not Applicable ['Underground
°Not Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches#
Fixtures#
CHECK®ALL APPLICABLE
ORange ❑Dishwasher ['Garbage Disposal • ❑Dryer ❑Water Heater
OFan OR Blower ❑Furnace ❑Electric Sign
DMotors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE `
5 fe 0 ';47 of(sh 5Gi
VALUE(Including labor and all materials including light futures)S e` -���-
MASTER ELECTRICIAN m164, -el CL' -e-
3/02
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