HomeMy WebLinkAbout0155394-Electric � CITY OF OSHKOSH No 155394
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3940 HEMLOCK CT Owner ADAM C/ANDREA J KRUEGER Create Date 05/02/2013
Contractor REMEDY ELECTRIC Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service New � Change � Temp � N/A I Type � Overhead � Underground
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Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
.
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Use/Nature of FR/BASEMENT REMODEL *"check#1360 '
Work I
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Fees: Valuation $1,900.00 Plan Approval $0.00 Permit Fee Paid $87.00
Issued By:j� Date 05/02/2013
�.7'
� Permit Voided � Parcel Id# 1282000900
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 �2—/�-
AgenUOwner
Address PO BOX 3563 OSHKOSH WI 54903 -3563 Telephone Number (920)379-9331 __
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 of Oshkosh
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 O.IHKO.lH
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$100.00 plus the
normal permit fee,which ever is greater.
OR
If vou are a contractor participatinQ in the Permit Fee Account Svstem and have adeguate fitnds, check here
if vou want this processed throu�vour account ❑
DATE S�Z� /�-
JOB ADDRESS 3g�l p f��iv��c�K CT
OWNER
CONTRACTOR ���Y %L��-TIZ�C
CHECK 0 ALL APPLICABLE
US CATEGORY
Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑T mporary TYPE ❑Overhead ONot Applicable
❑Change �ot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK G�1 ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE �,f�S��'� /��D(��,�
O-t1
VALUE(Including labor and all materials including light fixtures)$ ��� �
MASTER ELECTRICIAN
3/02
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