HomeMy WebLinkAbout0158027-Electric � CITY OF OSHKOSH No 158027
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2003 MOUNT VERNON ST Owner JEFFREY A/LAURA A WIRE Create Date 10/01/2013
Contractor HOULE ELECTRIC LLC Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service � New � Change � Temp � N/A ' Type � Overhead 0 Underground �
Volts Circuits 3 Luminaires 2
Amps _ Switches __ 3 Receptacles 6
Appliances ' — �
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Use/Nature of ;SFR/wiring for sunroom :
Work ,
'�*'ck#2848"'
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Fees: Vafuation $1,000.00 Plan Approval $0.00 Permit Fee Paid $70.00
Issued By: v�'` Date 10/01/2013
� Permit Voided Parcel Id# 1515420000
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 ne sary ap ls/bef_ arting sN ctivity.
Signature .� � `"t��—'�!_. _ Date /G'— � —/�
AgenUOwner
Address 6264 S RD _OSHKOSH WI 54904 -6866 Telephone Number (920)410-7220
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 f� `�,
P.O.Box 1130 � ':
Oshkosh,WI 54903-1130 � �;�'`
Phone(920)236-5050 `�---'
Fax (920)236-5084 � y %�l � ' ��
I 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 54903-1 1 28. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
!f vou are a contractor narticipating in the Permit Fee Account Svstem and have adequate funds check here
if you want this processed through vour account ❑ � �
DATE l Q "'� — � �
JOB ADDRESS ��'�/? Q �
P
OWNER � r�
CONTRACTOR `` � . � i �` �
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CHECK H ALL APPLICABLE
USE CATEGORY
�ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ONew OTemporary TYPE ❑Overhead �Iot Applicable
�Change �Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# � Circuits# �
Phase
Amps Switches# � Fixtures# �
CHECK 0 ALL APPLICABLE :
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign :
❑Motars ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE �U����
VALUE(Incladiag labor aad all materials iaciudiag light fiatures)$ C �v��
MASTER ELECTRICIAN
3/02