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� CITY OF OSHKOSH No 157893
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 727 W 11TH AVE Owner CWP LLC Create Date 09/23/2013
Contractor CT ELECTRIC _ _ Category 634-Residential-Service Change Plan
Inspector Adam Krause
Service New � Change � Temp � N/A Type � Overhead � Underground
Volts 120/240 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
L_ ,
Use/Nature of SFR/moving electrical meter box from inside house to exterior of house
Work
I
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- _�
Fees: Valuation $300.00 Plan Approval $0.00 PermitFee Paid $30.00
Issued By: `1"�� Date 09/23/2013
❑ Permit Voided'� Parcel ld# 1303820000
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 ssary appro s before starting such activity.
Signature Date —r�3^/�
AgenUOwner
Address 5783 ERIE ST BUTTE DES M(WI 54927 -9307 Telephone Number (920)420-3207
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 othervvise,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 Osiikosh
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 O.IHKOlH
ON THF WATFR
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete appiications 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 participatin� in the Permit Fee Account Svstem and have adeguate funds, check here
if vou want this processed throu�vour account ❑
/�, DATE 9 a 3- �3
JOB ADDRESS �� � w `I �V I
OWNER C � � �1'G ���-��1°�
CONTRACTOR �'� ��� L7`i^c C,
CHECK 0 ALL APPLICABLE
USE CATEGORY
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE�New ❑Temporary TYPE J�Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts /�-G / -2 `�C� Receptacles# Circuits#
Phase �
Amps 1��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 U rw e. fiP iZ v �
�� �)LJ'�S�G�c� �l !+ �e f 6 c iylf-t� tii %-P -� � � S ��
�a�-� L a
VALUE(Including labor and all materials including light fixtures) $ � �
MASTER ELECTRICIAN �� � � �'�J � � / � ��
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