HomeMy WebLinkAbout0103527-Electric (remodel)OSHKOSH
ON THE WATER
,Job Address 1621-1625 W 20TH AVE
Contractor JACK'S ELECTRIC INC
Service [~ New (~) Change
Volts 120/208
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner 20TH AVE LLC
Category 643- Commercial-Addition/Remodels
Amps 200
~ Temp
Type I~ Overhead
Circuits 22
Switches 14
No 103527
Create Date 08/14/2003
Plan
~ Underground
Fixtures
Receptacles
21
4O
Appliances Fan or Blower & Water Heater.
Use/Nature of COMM/ #1621/ Remodel.
Work
Fees: Valuation
Issued By:
$5,000.00 Plan Approval $0.00 Permit Fee Paid $105.00
Date 08/14/2003
Permit Voided
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
Agent/Owner
Address 117 N DOUGLAS ST APPLETON WI 54914 - 0 Telephone Number
(920) 733-1591
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
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
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
[f Fou are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you w'at~z this processed thorough your account []
DATEAUgust 12, 2003
JOBADDRESS 1621 N. 20th St
OV~NER Carlson Wagon Lite Trail
CONTRACTOR Jack's Electric Inc
CHECK [] ALL APPLICABLE
USE CATEGORY
ClSingle Family [3Duplex [21Multi-Fa,mily
SERVICE []New [Temporary
E]Change E3Not Applicable
[21Rental [5tCommercial l-qlndustrial
TYPE F1Overhead ~]Not Applicable
[Underground
FILL IN THE APPROPRIATE BLANK WITH THE .NUMBER
Volts 120 / 208 Receptacles# 40
Phase 3
Amps 200A Switches# 14
Circuits #
Fixtures #
22
21
CHECK [] ALL APPLICABLE
[2Range F1Dishwasher
glFan OR Blower F1Furnace
t2Motors [2Gas Pumps
[Garbage Disposal
EIA/C
[] Other
[3Dryer
mElectric Sign
DESCRIPTION OF ALL WORK BEING DONE Remo de 1
l~lWater Heater
VALUE (Including labor and a~materials including light fixtures) $ 5 , 000.00
MASTER ELECTRICIAN ack
3/02