HomeMy WebLinkAbout0155726-Eletric (service change) $
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� CITY OF OSHKOSH No 155726
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 494 WINDINGBROOK DR Owner JEFFREY W GLASSHEIM LIVING TRUST Create Date 05/21/2013
Contractor T RUCK ELECTRIC INC Category 634-Residential-Service Change Plan
Inspector Adam Krause
Service New � Change � Temp � N/A Type � Overhead � Underground I
Volts 120/240 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
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Use/Nature of SFR\UG Service for irrigation(future ligtht)
Work
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Fees: Valuation $500.00 Plan Approval $0.00 PermitFee Paid $30.00
Issued By: �� Date 05/21/2013
❑ Permit Voided� Parcel Id# 0614402900
In the performance of is work I agree to perform all work pursuant to rules governing the described construction.
While the City of Osh' sh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this pe application within an ea5 ent,the City strongly urges the permit applicant to contact the easement
holder(s)and to ec any necessary a rovals before rting such activiry.
Signature Date
AgenUOwner
Address 690 W 3 AVE OSHKOSH WI 54902 -5880 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 performed within two business days from the time the project is ready.
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City of Oshkosh
Ui��ision of Tnspection tiervices
P.O. Box 1 130 � �
Oshkosh,t�'I 5490:-1130
Phanet92p)236-505� �r
Fax (92Ci?236-508�2
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ELECTRICAL PERMIT APPLICATION °�� THF �v�-ER �
All information aFter bold categories must be prorided.
Incomplete applications wiil not be processed.
• Application{s)and fee(s) can be brought to City Hall,Room 205 or mailed to Inspection Services, PC)Bc�r ? i_�,
Oshkosh WI 549J3-1128. Comrnencing work without permit(s) will result in fees being doubled or$1UO.Ou ius tia�
norrna; permit fee:, which ever is greater. P
OR
�ti'ou are p contrq��or pQrtfciaatin �n the Per�nit Fee Account S �stem anrf have ade t�ate rrnr;s c.hzck i:cr�:�
l�tiou x-�ant thts rocessed throu Ir �our accoi�nt [� _
' DAT'E S�
JOB ADURESS_���� _L} b,�r
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OR'NERcs� �
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CUNTRACTOR� � .._.
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CHECK H A,.'�,L APPLICABLE
LrSE CATEGORY
❑Single Faniily �Duplex ❑hlulti-Family ❑Rental
�Cammercial ❑lndusttiat
SERVICE �iew OTemparary T�`PE ❑Overhead ❑Not Applicabie
�7Change C7Not Applicable
L�lnderground
FILL IN THE AppROPRIATE BLANK WITH THE NU1�IBER
Volts_ I ZV / 2�d Receptacles #
Phase__� � Circuits#
Amps�� Switches#
Fixtures#
CIiECK H ALL APPI,ICABL�
L�Range ❑Dishwasher C7Garba e Dis osal
❑Fan UK Blower OFurnace g p ��'er ❑`tiater :Ieate;
❑Motors �A�L ❑Electric Sign
[�Gas Pumps CJOther
DESCRIPTION OF AL,L VVU.ItK BEING llUNE. (�d
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�'ALUE (Inciuding 3abor and ali materials ' cluding fight Gxtu�es}-$, ��� �
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itiIAS?ER ELECTRICIAN ' �� �
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