HomeMy WebLinkAbout154675 -Electric (knob and tube in attic) 0 CITY OF OSHKOSH No 154675
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 247 W 12TH AVE — Owner MARY C RETZLOFF Create Date 03/08/2013
Contractor ACTION ELECTRIC Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service 0 New O Change 0 Temp • N/A Type Overhead
0 0 Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
Use/Nature of SFR/KNOB AND TUBE IN ATTAIC **check#3502
Work
I I
Fees: Val ion $1,000.00 Plan Approval $0.00 Permit Fee Paid
$70.00
Issued By:
Date 03/08/2013
El Permit Voided Parcel Id# 0901290000
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 3061 W ELBERG AVE _ — APPLETON WI 54914 -5734 Telephone Number (920)734-4020
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 Oshkosh
Division of Inspection Services
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050 �/ r�J
Fax (920)236-5084 Of HKO„1 H
ON THE WATFR
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$100.00 plus the
normal permit fee,which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account ❑
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JOB ADDRESS �/7 Z)` 4;4- Ate
OWNER /14 fr 1 11-C,11 RECEIVED
CONTRACTOR (k r (iecirc
MAR 0 8 2013
CHECK El ALL APPLICABLE ns,,A RT;e„E^:r OF
COMMUNITY DEVELOPMENT
USE CATEGORY INSPECTION SERVICES DIVISION
II4ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK 8 ALL APPLICABLE
ORange ❑Dishwasher ❑Garbage Disposal ❑Dryer OWater Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Othe�r//�� A//h.> �1
DESCRIPTION OF ALL WORK BEING DONE fl'-�✓ b i '� `h`=
U
VALUE (Including labor and all materials in in!' t fixtures)$ '(bob Q�
MASTER ELECTRICIAN / / 6; (� 7o
3/02