HomeMy WebLinkAbout0155292 - Electric 0 CITY OF OSHKOSH No 155292
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1730 ARLINGTON DR Owner ERIC W/JESSICA M KUBALEK Create Date 04/23/2013
Contractor KOLLMANN ELECTRIC LLC Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service 0 New O Change O Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits - 1 Luminaires 10
Amps Switches 4 Receptacles 8
Appliances Dishwasher, Garbage Disposal
Use/Nature of SFR/KITCHEN REMODEL, INSTALL 3 BATH FANS AND INSTALL 3 VANITY LIGHTS **check#2883
Work
Fees: ValtRtion -_ $1,900.00 Plan Approval $0.00 Permit Fee Paid $87.00
Issued Byv10
CC �y�i �r ((��� Date 04/29/2013
E Permit Voided Parcel Id# 1315890000
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 cure any nere_a�ovals before starting such activity.
Signature GG Date ( p2CJ
Agent/Owner
Address PO BOX 26 VAN DYNE -WI 54979 -26 _- Telephone Number (920)273-0701
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.
❑Motors ❑Gas Pumps DOther
DECRIPTION OF ALL WORK BEING DONE ��r-/�e?,m�a�L 1 �t. s _. i
—
City of Oshkosh
Division of Inspection Services
P.O. Box
Oshkosh,WI WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 �J
ON THF 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 ❑
DATE ,7"_(2 C._
JOB ADDRESS /730 Iiid rA A-
OWNER Ir .- /J 2 l
b G /e•
CONTRACTOR /j)/fi I n•N /i e c td-,•C 1- L, C
CHECK II ALL APPLICABLE
USE CATEGORY
Mingle Family ❑Duplex ❑Multi-Family DRental DCommercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead 14Not Applicable
❑Change jitNot Applicable DUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits# /
Phase
Amps Switches# Fixtures# i 0
CHECK 0 ALL APPLICABLE
ORange L Dishwasher &Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps DOther
DE CRIPTION OF ALL WORK BEING DONE a . f. ._._ -./" _ _ ...
/ 1 ��'
- - -' � � �'
s s
/p 41
VALUE (Including labor and all materials including light fixtures) $ /
MASTER ELECTRICIAN fer).y ,e,, �h,-r€,�......
3/02