HomeMy WebLinkAbout0153511 - Electric (svc chg) CITY OF OSHKOSH No 153511
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1102 E NEVADAAVE Owner GEORGE M POUBA Create Date 11/13/2012
Contractor HOEHNE ELECTRIC Category 634-Residential-Service Change Plan
Inspector Adam Krause
Service New • Change ❑ Temp 0 N/A J Type • Overhead O Underground
Volts 120/240 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
L _ _
Use/Nature of SFR/SERVICE CHANGE **debit acct
Work
Fees: Valuation $1,500.00 Plan Approval $0.00 Permit Fee Paid $77.00
Issued By: ;J o 7
Date 11/13/2012
❑ Permit Voided Parcel Id# 1511390000
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 N1798 JUNCTION LN BERLIN WI 54923 -8923 Telephone Number (920)379-8200
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.
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City of Oshkosh ,2:„ , ,k, , /L ,7 �'�. /Z: f--4 /1/(
Division of Inspection Services ,
P.O.Box 1130 /� , " `€ /�alieM
Oshkosh,WI 54903-1 130 (� .�
Phone(920)236-5050 '�pd /� ' ilsd c I6 �" _
Fax (920)236-5084 in...sped-
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ELECTRICAL PERMIT PPL!CA11O�! �W TI-IF WATER
All information after bold categories,must be provided.
Incomplete applications will notlbe processed.
. ® Application(s) and fee(s)can be brought to City Hall,Room 205 jr mailed to Inspection Services,PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without perrnit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
If you are a contractor participathrg in the Permit Fee Accou r to . and hav
i(vou Want this processed throueh Your account [] ade are rr ds check here
DATE ()
JOB ADDRESS /o2 A/ 1)4 �l
OWNER ) :4.' O CJ i t +�
CONTRACTOR A /J'C =!S G
t .4
CHECK H ALL APPLICABLE
U E CATEGORY
Single Family DDuplex DMulti-Family DRenta
DCommercial Dlndustrial
SERVICE DNew OTemporary TYP )Overhead
Change ❑Not Applicable DNot Applicable
•. ❑Underground
i3
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volty' D C Receptacles#E
Phase Circuits# •
Amps Switches# Fixtures#
CHECK H ALL APPLICABLE
°Range °Dishwasher 0Garbage Disposal °Dryer °Water Heater
°Fan OR Blower °Furnace DA/C °Electric Sign
DMotors °Gas Pumps El Other
DESCRIPTION OF ALL WORK BEING DONELZ '` 2- I _
42gyVALUE(Including labor and al serials including ti: t fissures)$ • 0,)
MASTER ELECTRI /- .-
•
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