HomeMy WebLinkAbout0155059 - Electric (install receptacles) CITY OF OSHKOSH No 155059
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 216 W BENT AVE Owner JENNIFER L BORK Create Date 04/16/2013
Contractor MY ELECTRIC CORP Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service O New 0 Change O Temp • N/A Type O Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
Use/Nature of SFR/Installing receptacles, lights and switches throughout the house.
Work
I I
II
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $30.00
Issued By: ,�� Date 04/16/2013
E Permit Voided I Parcel Id# 1502720000
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 easeni t,the City strongly urges the permit applicant to contact the easement /
holder(s)and to secur neces ppro before starting such activC
C 2&
Signature Date /7
Agent/Owner
Address 6012 KOELPIN RD OSHKOSH WI 54902 -9117 Telephone Number (920)231-0707
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
(41117-6)
Division of Inspection Services
P.O. Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 OfHKOJH
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 ❑
DATE1/16/2013
JOB ADDRESS216 W. Bent Ave.
OWNER Jennifer Bork
CONTRACTORMY Electric Corp.
CHECK El ALL APPLICABLE
USE CATEGORY
®Single Family I (Duplex Multi-Family ❑Rental ❑Commercial I (Industrial
SERVICE [iNew LiTemporary TYPE ❑Overhead [-Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK El ALL APPLICABLE
['Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace F1A/C ❑Electric Sign
'Motors I 'Gas Pumps flOther
DESCRIPTION OF ALL WORK BEING DONE
Install rcpt's, Lights, Switches.
VALUE(Including labor and all materials including light fixtures) $500.00
MASTER ELECTRICIAN
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