HomeMy WebLinkAbout2004-Electric (capture system)CITY OF OSHKOSH
106517
No
OSHKOSHELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job AddressOwnerCreate Date02/19/2004
3300 MEDALIST DRSMET INVESTMENTS LLC
ContractorEXCELLENCE ELECTRIC, INC.Category653 - Industrial-Addition/RemodelsPlan
ServiceTypeOverheadUnderground
NewChangeTemp
VoltsCircuits0Fixtures0
Amps0Switches0Receptacles0
Appliances
Use/Nature of GE POWER SYSTEMS / WASHWATER CAPTURE SYSTEM, JOB #3855
Work
Plan Approval$0.00
Fees: Valuation$900.00Permit Fee Paid$44.00
Issued By:Date02/19/2004
Permit Voided
Parcel Id #1413650000
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.
SignatureDate
Agent/Owner
PO BOX 78LITTLE CHUTEWI5414078920-687-2442
Address-Telephone Number
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.
Cityo£7shkosh � �� � ���� ��i
Division of Inspection Services - '' �
F:O.Box 1130 �L�� � �
�shkosh,WI 54903-1130 t� FEB 1 � t:'
lhone(920)236-5050
Fax (920)236-5084 : �- • - : 1 HK 1 H
. � � � ON THE WATF.R
ELECTRICAL PERMIT APPLICATION
All inforn�ation after bold categories must be provided.
Incomolete 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 I 128,
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
/f vou are a contractor DarticipatinQ in the Permit Fee Account Svstem and have adenuate (unds check here
if vou want this processed throu�vour account ❑
fiATE d�/7�d¢
JOBADDRESS �3�r� m�=DAt-lS'r _DiZi��E I
owrrEx_C�c-'������z S�Is�ns - /� C �c�mpressr�2
CONTRACTOR LXe�u�_=�:� LCL.c:Ti2�c�
CHECK �ALL APPLICABLE
`JSE CATEGORY
• .]Single Family �Duplex ❑Multi-Family ❑Rental ❑Commercial �Industrial
SERVICE ❑New OTemporary TYPE ❑Overhead �Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NIJMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK Bf 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
GIJf�Sd/6U.�i� G�/3�1�l,� S ST��✓I
'ALUE (Including labor and all m •ials including light fixtures) $ qQ��
� MASTER ELECTRICIAN �//�
lg$
�,B`�3��S � o� 0�`'3�az
44-��,f ,�
�� .