HomeMy WebLinkAbout0153525 - Electric (svc change) CITY OF OSHKOSH No 153525
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1682 THORNTON DR
Owner STEVEN J/SHARON A HANSEN Create Date 11/13/2012
Contractor CUMINGS ELECTRIC INC
--- Category 634-Residential-Service Change Plan
Inspector Adam Krause —
Service — - --
New • Change 0 Temp O N/A
— -- — ❑ Type ❑ Overhead Underground
Volts 120/240 Circuits — —
Luminaires
Amps 100 Switches
Appliances i — — — — Receptacles
Use/Nature of SFR/SERVICE CHANGE **debit acct
----- -----
Work Fees: Valuation $700.00 Plan A --- ---— — --- -- --- --- ---
(7� Approval $0.00 Permit Fee Paid $39.00
Issued By: 1. -- --
Date 11/13/2012
❑ Permit Voided I Parcel Id# 1317470000
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 PO BOX 749 -74
54957 5
— NEENAH WI 749 54 Telephone Number (920)722-1240
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.
iv 13 2012 9: 46AM CUMINGS ELECTRIC, INC.
il
920-722-0769 p. i
ivjj of Inspection 9etvice■
215 Church Avenue
P.O. Hoc 1130
?ahkoigh 0) 53903-1130
i*ax (920) 936-506
Phone (920) 236-5046
ELECTRICAL PERMIT' APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 11/13/12
JOB ADDRESS 1682 Thornton Drive
JOB NO. B540-00
OWNER STEVE HANSEN
CONTRACTOR CUMINGS ELECTRIC INC.
CHECK ALL APPLICABLE
USE CATEGORY, SINGLE FAMILY® DUPLEX❑ MULTI-FAMILY❑ RENTAL❑
COMMERCIAL❑ INDUSTRIAL
SERVICE' NEW ❑ CHANGE E TEMPORARY
❑ NOT APPLICABLE ❑]
TYPE, OVERHEAD ❑ UNDERGROUND ® NOT APPLICABLE ❑
NUMBER OF FIXTURES _ SWITCHES _ RECEPTACLES _ CIRCUITS
AMPS 100 VOLTS 12/24.Q PRASE 1
CHECK ALL APPLICABLE
RANGE ❑ WATER HEATER ❑ GARBAGE DISPOSAL ❑ DRYER ❑
DISHWASHER ED FAN OR BLOWER
❑ FURNACE 0 A/C ❑
ELECTRIC SIGN ED MOTORS ❑ GAS PUMPS ❑ OTHER
DESCRIPTION OF ALL WORK BEING DONE SERVICE CHANGE
VALUE (including labor and all materiala including light fixtures') 7i QQ.OQ
PBPMIT TIM:
a6A$TER ELECTRICIAN Richard Wenzel
Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100. 00 plus the normal permit fee, which ever is greater.
OR
Check here if you want this processed through your account Eg
#100-0750-2515-00000
Received Time Nov. 13, 2012 8:46AM No. 1624