HomeMy WebLinkAbout0158530-Electric � CITY OF OSHKOSH No 158530 '
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 183 W 25TH AVE Owner JACK T/TAMMY L SMITH Create Date 10/29/2013
Contractor LUXURY ELECTRIC LLC _ Category 612-Residential-Single Family Addition/R Plan .
Inspector Adam Krause
Service � New � Change � Temp � N/A ' Type � Overhead � Underground I
Volts Circuits Luminaires
Amps Switches _ Receptacles
Appliances
�I
,
Use/Nature of ,SFR\100 UG sub-feed to detached garage
Work
; !
i
- - — -- -
Fees: Valuation $1,500.00 Plan Approval $0.00 PermitFee Paid $87.00
Issued By: �� Date 10/29/2013
❑ Permit Voided Parcel Id# 1411810000
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 6071 SPRINGBROOK RD OMRO WI 54963 -8227_ Telephone Number (920)685-6270
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
Fax (920)236-5084 O HKO H
ON THF V✓ATFR
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
lncomplete applications witl 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 participating in the Permit Fee Account Svstem and have adeguate funds, check here
if you want this processed through vour account ❑
DATE D��S. ��
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JOB ADDRESS ��3 �'`� �°2`��`f � l/�S�rU�n
ow1vER ,�"'�k ��;�ti
RECEIV�
CONTRACTOR ��.�'c��y ����� �-��� � 0 C T 2 8 2013
CHECK m ALL APPLICABLE v�€'.auT�2E�r oF
��°����rtr'�IT�'DEVELOP1fE`'
MVSPEt'7E�ri c�R��pCF.S DI�7Sl�;F
U E CATEGORY
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ONot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts ��� /a� Receptacles#_y� Circuits# `3
Phase S�r,���
Amps o2�.Tv Switches# .3 Fixtures#
CHECK m ALL APPLICABLE
❑Range ❑Dishwasher ❑GarbageDisposal ❑Dryer ❑WaterHeater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
.s /
DESCRIPTION OF ALL WORK BE NG DONE �/`c�c-� /�/� � � ��ru /�a� �
�u..J � � G- S� �� !"UV e�
G✓� � N�c.� � e�� C
VALUE (Including labor and all materials includin light fixtures) $ la.S�cJ� �
MASTER ELECTRICIAN
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