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Home My WebLink About0155636-Electric � CITY OF OSHKOSH No 155636 OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 303 OXFORD AVE Owner ADRIEN H/CARLA M HOLTZMAN Create Date 05/14/2013 Contractor HOMEOWNER Category 612-Residential-Single Family Addition/R Plan Inspector Adam Krause Service New 0 Change � Temp � N/A Type � Overhead 0 Underground I Volts Circuits Luminaires Amps Switches Receptacles Appliances Use/Nature of FR\Finsih basement areas Work Fees: Valuation $200.00 Plan Approval $0.00 PermitFee Paid $30.00 Issued By: � Date 5/14/2013 � Permit Voided I Parcel Id#0403150000 The undersigned,in applying for an Electric Permit to perform electrical work within a single family home,owned and occupied as the principle residence by the undersigned,hereby acknowledges per City Municipal Code Section 11-22,that other individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the City of Oshkosh to perform said work. 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 (',(l(�,.� �� Date � AgenUOwner Address �p� (��fd�� OSHKOSH WI 5490- 4535 Telephone Number - � 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 perfortned 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 f--IKO f I--I 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 vou are a contractor partici ating in the Permit Fee Account Svstem and have adepuate funds, check here if vou want this processed throu�vour account ❑ DATE J� �y �-3 JOB ADDRESS�� C.T x"�� G�� OWNER�� U��1�Y1O�1� CONTRACTOR �G►�Y�Q, (S W Y`Q.� CHECK 0 ALL APPLICABLE USE CATEGORY '�ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial SERVICE ❑New ❑Temporary TYPE ❑Overhead �Not Applicable ❑Change �ot Applicable ❑Underground FILL IN THE APPROPRIATE BLANK WITH THE NUMBER Volts � / Receptacles# Circuits# Phase Amps Switches# Fixtures# CHECK�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 / C�- VALUE(Including labor and all materials inciuding light fixtures) $ ��`J� MASTER ELECTRICIA //' - �, . 3/02