HomeMy WebLinkAbout0153034 - Electric (new addition) CITY OF OSHKOSH No 153034
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2335 SHORE PRESERVE DR Owner GARY/SHARLA NORKOFSKI Create Date 09/04/2012
Contractor CT ELECTRIC Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service 0 New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground
Volts 120/240 Circuits 2 Luminaires 5
Amps 100 Switches 4 Receptacles 6
Appliances Hot Tub
Use/Nature of !SFR/New addition to existing house/adding a four seasons room off back of house **check#688
Work
Fees: Valuation $700.00 Plan Approval $0.00 Permit Fee Paid - $39.00
Issued By: 77'7 iJ Date 10/17/2012
❑ Permit Voided] Parcel Id# 1281320000
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 5783 ERIE ST BUTTE DES M(WI 54927 -9307 Telephone Number (920)420-3207
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
Division isi o I
on of Inspection Services
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050 �/
Fax (920)236-5084 IJHKE.1H
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 7 d— /2
JOB ADDRESS 23 3 c f c' n S'e tr u Q
OWNER 61(2../N y ,3 (-he, /VCS e 4-0
c4 2
CONTRACTOR en L / c- 0(`C
CHECK El ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead .e1Not Applicable
DChange SNot Applicable DUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts /-20 / -2 e/(J Receptacles# Circuits# Z
Phase
Amps /J 0 Switches# L� Fixtures#
CHECK El ALL APPLICABLE
❑Range DDishwasher DGarbage Disposal DDryer DWater Heater
❑Fan OR Blower ❑Furnace ❑A/C f ❑Electric Sign
❑Motors ❑Gas Pumps Other f-/ -r ru a
DESCRIPTION OF ALL WORK BEING DONE 6-u-f- l ' j z-,y `j )45/
f�v 77:i l; Pel of
VALUE(Including labor and all materials including light fixtures) $ /6e)
MASTER ELECTRICIAN .
3/02