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Home My WebLink About0157974-Electric � CITY OF OSHKOSH No 157974 OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 845 HERITAGE TRL Owner KERRY D HUBERT'Y Create Date 09/27/2013 Contractor HOMEOWNER _____ Category 612-Residential-Single Family Addition/R Plan Inspector Adam Krause Service New � Change � Temp � N/A � Type � Overhead 0 Underground � Volts Circuits Luminaires Amps Switches __ Receptacles Appliances refrigerator,DW,microwave � � Use/Nature of 'SFR/interior wiring for new electrical ouitlets and lighting per kitchen remodel Work ,i Fees: Vafuation $500.00 Plan Approval $0.00 Permit Fee Paid $30.00 Issued By: �� Date 9/27/2013 Permit Voided j Parcel Id#0613980000 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 individuais 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 se a prov before starting such activiry. Signature Date ! � ? � AgenUOwner Address OSHKOSH WI 5490- 8009 Telephone Number 233-4464 ' 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 Oshl:osh Di��ision of Inspection Services � P.O.Box 1130 � Oshl:osh,WI54903-1130 Phone(920)236-5050 �� Fa� (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 Cit�� Hall,Room 205 or mailed to Inspection Services,PO Box 1128, Oshkosh WI 54903-1128. Commencing work without permit(s)w°ill result in fees being doubled or$100.00 plus the normal permit fee, which ever is greater. OR If vou are a contractor participatin� in the Permit Fee �ccount System and have adequate funds, check- here � if volt warzt this processed throu�h vour• account ❑ DATE 9��-/3 JOB ADDRESS � �i7� �- �I OWNER �' v CONTRACTOR ��e/�- CHECK 0 ALL APPLICABLE USE CATEGORY �h5ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial SERVICE ❑New� ❑Temporar�- TYPE ❑Overhead �Not Applicable �Change �Not Applicable �lnderground FILL IN THE APPROPRIATE BLANK WITH THE NUMBER Volts��0 / Receptacles # i � Circuits# � Phase — � Amps �_ Switches # ( Fixtures# �D CHECK L�I ALL APPLICABLE ❑Range ��$ishwasher �'6�arbage Disposal �Dryer ❑Water Heater ❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign ❑Motors ❑Gas Pumps ,�9ther �L� J!JG J-e. DESCRIPTION OF ALL WORK BEING DONE / J\/ VALUE (Inciuding labor and all materials including light figtures)$ �� MASTER ELECTRICIAN