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Home My WebLink About0158266-Electric � CITY OF OSHKOSH No �5s2ss OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 433 MONROE ST Owner LINDA M MONROE Create Date 07/30/2013 Contractor HOMEOWNER Category 612-Residential-Single Family Addition/R p�an Inspector Adam Krause Service New � Change 0 Temp � N/A Type � Overhead � Underground I, Volts Circuits Luminaires Amps Switches Receptacles Appliances � Use/Nature of ISFR/16'x 18'Addition'to be used as a masterbedroom. An existing bedroom will be converted into closet and bathroom. Work ' ' � Fees: Valuation $400.00 Plan Approval $0.00 PermitFee Paid $30.00 Issued By: Date 10/15/2013 ❑ Permit Voided I Parcel Id# 0404160000 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 t secure any ne sary approvals before starting such activity. Signature Date /' 6 �/_�'� �� AgenUOwner Address OSHKOSH WI 5490- 5145 Telephone Number 279-0379 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 othenivise,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 � Fax (920)236-5084 �S�K�S�—.� : 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 54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which ever is greater. OR I��ou are a contractor varticipating in the Permit Fee Account Svstem and have adequate fi�nds, check here if vou want this processed throu�vour account ❑ DATE � � - �s� �a JOB ADDRESS `�3 3 /f'1 a r,s�o.t s� OWNER ,D�.,e- �- L,��+ e.- ls?� r-- � CONTRACTOR 11rn�2 Ow�� j�,' CHECK H ALL APPLICABLE USE CATEGORY �ingle 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 DESCRIPTION OF ALL WORK BEING DONE �J�'>�7� �s � a,r�c�f�rb� 6��aam , VALUE(Including labor and all materials including light fixtures) $ `Y"�Cl MASTER ELECTRICIAN �°'''�� ^a'ti'�e�wan7r� 3/02