HomeMy WebLinkAbout0157369-Electric � CITY OF OSHKOSH No 157369
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON TNE WATER
Job Address 574 OAK ST Owner STEVEN/KATHY FOLLETZ Create Date 08/22/2013
Contractor HOMEOWNER Category 612-Residential-Single Family Addition/R p�an
Inspector Adam Krause
Service � New � Change � Temp � N/A Type 0 Overhead � Underground �
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
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Use/Nature of SFR/New detached garage wiring
Work
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Fees: Valuation $700.00 Plan Approval $0.00 Permit Fee Paid $46.00
Issued By: Date 8/22/2013
a Permit Voided I Parcel Id# 1103730000
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 s e any necessary ovals before starting such activity.
Signature � Date
UOwner
Address �j 7� �,��,( S� OSHKOSH WI 5490- 4621 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,WI54903-1130
Phone(920)236-5050
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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-ll28. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee, which ever is greater.
OR
If vou are a contractor participating in the Per•mit Fee Account Svstem and have adeguate funds, check here
if vou want this processed throu�vour account ❑
DATE �� z- ��
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JOB ADDRESS �� � �t-1I�C S � , US N��
OWNER S�'�v�2-'�, `.-.. �b�`�-��—
CONTRACTOR S.�t� —
CHECK Lf ALL APPLICABLE
USE CATEGORY
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE�New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK�ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other :
,�� \ ca�!-l .n��C :
DESCRIPTION OF ALL WORK BEING DONE �1��2ZU R.+�n C^�r���,� -� I-Ip�S-e-
b �!�r ,;;r - 1 3
LY'� `--i
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VALUE(Inciuding labor and all materials including light fixtures)$�y�����U '
MASTER ELE IAN �
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3/02