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I�"� CITY OF OSHKOSH No 157933
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1534 BOWEN ST Owner MICHAEL G MORRISSEY Create Date 09/18/2013
Contractor KOLLMANN ELECTRIC LLC Category 612-Residential-Single FamilyAddition/R Plan
Inspector Adam Krause
Service New � Change � Temp � N/A Type 0 Overhead � Underground I
Volts Circuits 1 Luminaires 6
Amps Switches _ 3 Receptacles 6
Appliances �-
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Use/Nature of FR/KITCHEN REMODEL "'check#3084
Work j
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Fees: Valuation $1,750.00 Plan Approval $0.00 Permit Fee Paid $87.00
Issued By: �1 Date 09/25/2013
❑ Permit Voided I Parcel Id# 1511850000
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
AgenUOwner
Address PO BOX 26 VAN DYNE _WI 54979 -26 Telephone Number (920)273-0701
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 f
Fax (920)236-5084 � �
� :
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 ar$100.00 plus the
normal permit fee,which ever is greater.
OR
If you are a contractor participating in the Permi[ Fee Account System and have adeguate funds check here
if vou want this processed throu�h ,your accoirnt ❑
DATE [ �� ��
JOB ADDRESS �S�3� ���� � RECEI�ED
OWNER ;(�e !/yl�rr�ss�'y SEP 2 5 2013
CONTRACTOR I�O��rHasi„ ��PC1'���c, G-
L �
DEPART�tE\T OF
C0�1\�U�ITY DE�'ELOP�1EVT
CHECK Q ALL APPLICABLE INSPECTiO�SER1'ICES D1�7SlOti
USE CATEGORY
�,Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles#� Circuits#�
Phase '
Amps Switches# � Fixtures# � �
CHECK 0 ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE r'�/ G��r` ��°w�a�e /
) -�ry c�`
VALUE (Including labor and all materials including light tixtures)$ / �.S(J
MASTER ELECTRICIAN rZ�i .^—'-
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