HomeMy WebLinkAbout0155753-Electric /�'� CITY OF OSHKOSH No �55�53
OSHKOSH ELECTRIC PERMIT -APPUCATION AND RECORD
ON THE WATER
Job Address 2455 SHORE PRESERVE DR Owner SCHMIDT BROTHERS CUSTOM HOMES I� Create Date 05/03/2013
Contractor TEAM SERVICES INC Category 611 -Residential-New Single Family Wirin Plan :
Inspector Adam Krause
Service � New � Change Q Temp 0 N/A Type � Overhead � Underground �
Volts 120/240 Circuits 15 Luminaires 15
Amps 100 Switches 27 Receptactes 45
Appiiances Range,Dishwasher, Fumace,Garbage Disposal,A/C,Dryer,Water Heater i,
i
I
Use/Nature of NSFR/WIRING FOR NEW HOME "check#66056
Work
',
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Fees: Valuation $4,000.00 Pian Approval $0.00 Permit Fee Paid $121.00
Issued By: �� Date 05/22/2013
❑ Permit Voided I Parcel Id# 1281520000
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
AgenUOwner
Address 2602 AMERICAN DR APPLETON WI 54914 -9010 Telephone Number (920)738-5885
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 HKO H
ON THF W/�TFR
ICJ' �Q�# --�Q��I 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 contractnr participating in the Permit Fee Account Svstem and have ad�uate funds check here
if vou want this processed through vour account ❑
DATE � �`S 13
JOB ADDRESS �LI�� J /'La 1^C ���f�r� C
�E���V��
OWNER � G�w�� cu l7cdS
CONTRACTOR / �Gc rM ��r'J � c c i MAY 2 0 2013
DEY.aRT11E\'I OF
CHECK BI ALL APPLICABLE COJ1�iU\ITY DE�'ELOP1fEVT
INSPEC'f10V SER1'iCES Di�'iS10V
USE CATEGORY
�ingle Family ❑Duplex ❑Multi-Family ❑Rental OCommercial ❑Industrial
SERVICES�ATew ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable �ETnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts /rzd / �`�� Receptacles# �� Circuits# 1�
Phase �
Amps I�v J
Switches# 02 7 Fiatures# �S
CHECK �ALL APPLICABLE
�Itange �Dishwasher �Garbage Disposal �Hryer ,�Water Heater
❑Fan OR Blower �Furnace �A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DO� 1�l � � r r /\/ � /T�t� -e
� �
VALUE(Induding labor and all materials including light fixtures) � � r �o�/
MASTER ELECTRICIAN � �� � �
3/02