HomeMy WebLinkAbout0153032 - Electric (kitchen . living room) CITY OF OSHKOSH No 153032
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1117 W 7TH AVE Owner RICHARD H TARNAWSKI Create Date 10/17/2.012
Contractor HOMEOWNER Category 612-Residential-Single Family Add ition/R Plan
Inspector Adam Krause
Service 0 New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground
Volts — Circuits
Luminaires
Amps _ Switches _ Receptacles
Appliances ishwasher,garbage disposal
Use/Nature of SFR/removing and rewiring first floor kichen, living room,dining room,den and laundry room/all work will meet local and state codes
Work for electrical
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $77.00
Issued By: Date 10/17/2012
Permit Voided , Parcel Id# 0606480000
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 -•: ation within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to sec - -•' ne - sary approval fore starting such activity.
Signature /! • Date /a/7/0/v
•
Agent/Owner
Address OSHKOSH WI 5490- 5737 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
(11116
Division of Inspection Services
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 OfHKOfH
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 AV/7/00/2
JOB ADDRESS /1/7 W . °JTN AUL.
OWNER f-�tC1L T r!/ 1AJ a k '/
CONTRACTOR
CHECK El ALL APPLICABLE
USE CATEGORY
[Dingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑•ew ❑Temporary TYPE ❑Overhead ❑Not Applicable
Whange ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK El ALL APPLICABLE
❑Range IErDishwasher El/Garbage Disposal ❑Dryer ID Water Heater
❑Fan OR Blower ❑Furnace ❑A/C DElectric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE gEM0Vf A74 b R,EPLAc 1NI tiNG
ant' iii57- F��v� Kt T�f tT/ / 4 v i N� le - lA4 .D/ eorrti
BEN ) LA-ti l•tt-y Al •
VALUE (Including labor and all materials including light fixtures) $ a) D?fb
MASTER ELECTRICIAN
3/02