HomeMy WebLinkAbout0156549-Electric (new service) /�', CITY OF OSHKOSH No 156549
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 972 E SUNNYVIEW RD#62 Owner JOHN SHULTIS Create Date 07/03/2013
Contractor M.R.TEAS INC Category 610-Residential-New Single Family Servi Plan
Inspector Adam Krause
Service i� New 0 Change � Temp � N/A � Type � Overhead � Underground '
Volts 120/240 Circuits Luminaires
Amps 200 Switches ______ Receptacles
Appliances �
�
;
� __�i
Use/Nature of OBILE HOME/NEW SERVICE TO MOBILE HOME
Work
Fees: Valu 'on $850.00 Plan Approval $0.00 Permit Fee Paid $62.00
Issued By: Date 07l03/2013
❑ Permit Voided � Parcel Id#
In the performance of this work I agree to perform all,�nrk{�drsaar� overning the described construction.
While the City of Oshkosh has no authority to enforce se ent restrictions o hich it is not a party,if you perform the work
described in this permit app' tion w' i an se ,t City s ngly urges th permit ap lica ent
holder(s)and to secure an a a r al o sta �
Signature Date — �
Agen
Address 7065 WOODENSHOE RD NEENAH WI 54956 -9747 Telephone Number (920)720-2288
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 Of HKO.IH
Fax (920)236-5084 �
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$100.00 plus the
normal permit fee,which ever is greater.
OR
Ifvou are a contractor participating in the Permit Fee Account Svstem and have adequate fi�nds, check here
i1'vou want this processed throu�vour account ❑
�---►�4- �C�l, E i K� V1�}� � DATE �� ' ��
JOB ADDRESS ���� 3 ��— � �,c ✓�✓��� �t i4'��
OWNER �y] �{ 0 ��i fC ax� i✓�' C. � C
corrT�cTOR__ �t � �� ��� � -�nJ�
CHECK H ALL APPLICABLE
USE CATEGORY .
�gle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE�Iew ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable �Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Votts �v2� /Z `{n Receptacles# Circuits#
Phase / �
Amps��C�C� Switches# Fixtures#
CHECK�ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C �% J �Electric Sign
❑Motors ❑Gas Pumps ❑Other ��� �(��/'� 7�f�yti-�
DESCRIPTION OF ALL WORK BEING DONE ��t°�G(J J P�iJ r� -� �0 /1(/�'✓`�
d�•
VALUE(Including labor and all materials in uding light tixtures)$ � �Z��^
.�} �
MASTER ELECTRICIAN %�� �� � 7/ �� �� �
�
3/02