HomeMy WebLinkAbout0156390-Electric � CITY OF OSHKOSH No 156390
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 814 CENTRAL ST Owner BERNS W COOK Create Date 06/21/2013
Contractor VAN ERT ELECTRIC CO INC Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service New � Change 0 Temp � N/A � Type � Overhead � Underground
Volts Circuits Luminaires 4
Amps Switches Receptacles 7
Appliances
Use/Nature of SFR/BATHROOM REMODEL
Work
Fees: Valuation $750.00 Plan Approval $0.00 Permit Fee Paid $54.00
Issued By: _� Date 06/26/2013
❑ Permit Voided i Parcel Id# 1005530000
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
Agent/Owner
Address 2000 PROGRESS WAY KAUKUANA WI 54130 -9562 Telephone Number (920)766-3888
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,WI54903-1130
Phone(920)236-SO50
Fax (920)236-5084 01HK�
ON THF WATFR
ELECTRICAL PERMIT APPLICATION
All informati�n after bald categories must be provided.
Incomplete applicatians 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 contracfo�urticipoting in the Permii Fee Accaunt Svstein and have adequate funds check here
r1 vnu want this processed throu h your account ❑
DATE�—� �1 —
JOB ADDRESS /
OWNER
-7-�� D R�CEIVED
CONTRACTOR �'� C-- JUN 2 5 ZOi3
CHECK EI ALL APPLICABLE DEPARTIIE\T OF
�SE�CATEGORY
I,VSPECTfO.V SER TrE���SIQV
�3S'mgle Family ODuplex ❑Multi-Family ❑Rental ❑Commercial �Industrial
SERVICE �New ❑Temporary TYPE ❑Overhead ONot Applicable
❑Change ONot Applicable �Underground
FILL IN THE APPROPRIATE BLANK WITFi T�NUMBER
Volts / Receptacles#�_ Circuits#
Phase , `
Amps Switches# F���{ ��'
CIiECK B1 ALL APPLICABLE
�Rar►ge � as� OGazbageDisposal . �ryer ❑WaterHeater
❑Fan OR Blower �Furnace ❑A/C OElectric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF L WORK BEING DONE
D 1�1r1�ll a .
�
VALUE(Including labor and all materiats including light i"iztures)�,' �Z_
MASTER ELECTRIC
3/02
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