HomeMy WebLinkAbout0155202 - Electric (repairs from ice storm) CITY OF OSHKOSH No 155202
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1905 WHITE SWAN DR Owner TROY M/LORI A DAUN Create Date 04/23/2013
Contractor WITZKE ELECTRIC INC Category 634-Residential-Service Change Plan
Inspector Adam Krause
Service b New • Change O Temp 0 N/A Type • Overhead O Underground
Volts Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
Use/Nature of SFR\Repairs following ice storm
Work
Fees: Valuation $450.00 Plan Approval $0.00 Permit Fee Paid $30.00
Issued By: !�'� Date 04/23/2013
❑ Permit Voided Parcel Id# 1523780000
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 155 E PACKER AVE OSHKOSH WI 54901 -1659 Telephone Number (920)235-6572
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.
— — .— e - 1$4 I V —�
MASTER ELECTRICIAN 133, 0
APR.23.2013 8:08AM WITZKE ELECTRIC P.1/i 1 ��v
City of Oshkosh NO.9701e
Division of Inspection Services
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084
ON THE WATf
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 perm.it(s)will result in toes being doubled or$100.00 plus the
normal permit fee,which ever is greater.
ORe__-__f_ ands •,_ . ,ee
if you want tAis grocesuJ ihrouzlLy_OUr accaf►�.f. ID
DATE `/' 2 3 /3
JOB ADDRESS 1?0 5 r i a Q
OWNER Lo r 7 d...........vet„, -
'r
CONTRACTOR Wr+ E 1e/ ti, I1C . '
CHECK ii5 ALL APPLICABLE
U CATEGORY
Single Family , ElDuplex ❑Multi Family ORental OCommercial DIndustriai
SERVICE ( Tew OTemporary TYPE ❑Overhead C]Not Applicable
t„ haige ❑ n.d
Not Applicable DUndergrou
FILLig THE APPROPRIATE BLANK WITH THE MIPER
Volts /aa AN-tD Receptacles#, ., Circuits#
Phase I
Amps /Oa Switches# Fixtures#
CHECK Ed ALL APPLICABLE
ORange ❑Dishwasher ❑Garbage Disposal , ❑Dryer OWater Heater
❑Fan OR Blower CJFurnace DA/C ❑Electric Sign
❑Motors. ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DO - __ - .. ' -
VALUE(Including labor and all matcrlals including light fixtures)$ 'V 41 11 p
MASTER O
ELECTRICIAN ,,.
3/02