HomeMy WebLinkAbout0158519-Electric � CITY OF OSHKOSH No 158519
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1410 INDIGO DR Owner ELLEN VANDERMOLEN Create Date 10/29/2013
Contractor KOLLMANN ELECTRIC LLC Category 610-Residential-New Single Family Servi Plan :
Inspector Adam Krause
Service � New � Change � Temp � N/A Type � Overhead � Underground I�
Volts 120/240 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances -
i
�
Use/Nature of MOBILE HOME/wire new mobile home to electric pedestal
Work
*'ck#3125**
I
i
- _ _I
Fees: Valuation $500.00 Plan Approval $0.00 PermitFee Paid $30.00
Issued By: � Date 10/29/2013
� Permit Voided Parcel Id# 1307310100
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 _
Fax (920)236-5084 �-K H
aN'rMF wnree
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
If vou are a contractor participatinQ in the Permit Fee Account System and have adeguate funds, check here
irvou want this�rocessed through ,your account ❑
DATE lC�'o� " �3
JOB ADDRESS / ��� ��-�I.�� Df;
OWNER �/ov�l l�•y►r� RECEIVED
CONTRACTOR ��/��a��•, r%�cf�,�� L L � OCT 2 8 2013
CHECK 0 ALL APPLICABLE �EP,�Rr;��E:�z oF
C0�1�tU'.OiT4'L�£o'gLOP1fE'.YT
USE CATEGORY iNSPECTidti�FRV;CES Di�"ISIOV
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change C�1ot Applicable �Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts � /°�� Receptacles# Circuits#
Phase �
Amps fGi'S 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 nALL WORK BEING DONE '�f�e .,/��2l� /Yfr�o,(2� /-�d�P tv
.�IeC�'ri� /'ed';S7�G �
pc
VALUE(Including labor and all materials including light fixtures) $�Q
MASTER ELECTRICIAN �
3/02