HomeMy WebLinkAbout0156518-Electric (service change) � CITY OF OSHKOSH No 156518
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 629 BOYD ST Owner GERALD W GIALDELLA Create Date 07/03/2013
Contractor HOMEOWNER Category 634-Residential-Service Change Plan
Inspector Adam Krause
Service New � Change � Temp � N/A � Type 0 Overhead � Underground �
Volts 220 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
Use/Nature of SFR/Service change
Work
*ck#308'*
I
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Fees: Valuation $950.00 Plan Approval $0.00 Permit Fee Paid $70.00
Issued By:`J� Date 7/3/2013
� Permit Voided I Parcel ld#0405860000
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 sec any necessa ap vals bef r s rting such activity.
Signature q Date '�- � " �-�
AgenUOwner
Address GERALD W GIALDELLA SHELBYVILLE TN 3716- 6402 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.
City of Oshkosh
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fa�c (920)236-5084 Of HKOf H
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$100.00 plus the
normal permit fee, which ever is greater.
OR
If vou are a contractor participating in the Permit Fee Account Svstem and have adequate funds, check here
if vou want this processed throu�h vour account ❑
3 � �
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JOB ADDRESS C��/ Sa' �� ��7
OWNER���R �G� ���A I G1� .P //g
CONTRACTOR
CHECK 0 ALL APPLICABLE
USE CATEGORY
I�ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑ ew ❑Temporary TYPE [BOverhead ❑Not Applicable
�hange ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts �>�/ Receptacles# Circuits#
Phase /�'
Amps / a� Switches# Fixtures#
CHECK�ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE
�\�rU� G� � 4 -✓e �
VALUE(Including labor and all materials incl ing light fixtures)$ ��a.�
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MASTER ELECTRICIAN rct l / //>
3/02