HomeMy WebLinkAbout0158587-Electric � CITY OF OSHKOSH No 158587
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1821 HOLLISTER AVE Owner DAVID/MARY M LOPATA Create Date 10/16/2013
Contractor VAN ERT ELECTRIC CO INC Category 612-Residential-Single Family Addition/R Plan
Inspector Adam Krause
Service New � Change � Temp � N/A , Type � Overhead � Underground '
Volts 120 Circuits 2 Luminaires
Amps 20 Switches 6 Receptacles 2
Appliances �
I
�
Use/Nature of SFR/Remodeling the 1st and 2nd floor bathrooms. The rooms will be gutted,new insulation,drywall cabinets and tile.
Work
,
----
Fees: Valuation $1,400.00 Plan Approval $0.00 Permit Fee Paid $87.00
Issued By: Date 11/04/2013
❑ Permit Voided Parcel Id# 1200430000
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 2000 PROGRESS WAY KAUKUANA WI 54130 -9562 Telephone Number (920)766-3888_
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,WI54903-1130
Phone(920)236-5050
Fax (920)236-5084 O �(O �.J
1 It\ I I
ON THE WATF.R
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$100.00 plus the
normal permit fee,which ever is greater.
OR
If vou are a contractor narticipating in the Permit Fee Account S stem and have ade uate unds chec,E here
if vou want this processed through vour account ❑
DATE �� I� i3
JOB ADDRESS � 0�� �(S�"C.V� `r"CV'� -
OWNER �Z�
CONTRACTOR �- � �I�--�-- `�
CIiECK B1 ALL APPLICABLE ����1��
E CATEGORY
ingle Family ❑Duplex CJMvIti-Family ❑Rental ❑Commercial �Industriat
SERVICE ONew OTemporary TYPE ❑Overhead ONot Applicable
❑Change �Not Applicable OUnderground
FILL IN THE APPROPRIATE BLANK WITA T�NUMBER
Volts �� / Receptacles# o� Circuits#,�_
Phase 1
Amps aU Switches# Fixtnres# ��
CHECK G�1 ALL APPLICABLE
��$e �Dishwasber �Garbage Disposal . ❑Dryer ❑Water Heater
❑Fan OR Blower �Furnace OA/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE �AI'YL� �cL,YVU'��'r"—
VALUE(Including labor and all materials including light fiztures)$ �4�'/ Q�� /r�1 �
/ �F' � U IJ
MASTER ELECTRICIAN �L� .Pd`�
3/02