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OSHKOSH
ON THE WATER
Job Address 500-550 S KOELLER ST
CITY OF OSHKOSH
No
123568
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
RIVER VALLEY ONE LLC
Create Date 02/20/2007
Service
b New
o Change 0 Temp
. N/A
Type 0 Overhead
Plan
o Underground
Contractor
TOWN & COUNTRY ELECTRIC
Category 643 - Commercial-Addition/Remodels
Volts
Circuits
Luminaires
Receptacles
Amps
Switches
Appliances
Use/Nature of COMM (550 - Verizon Wireless) - Wiring for interior remodel for new tenant.
Work
Fees: Valuation
$20,000.00
O/n1/O
Plan Approval
$0.00
Permit Fee Paid
$273.00
Issued By:
Date 02120/2007
D Permit Voided I
Parcel Id # 0611620000
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
PO BOX 627
APPLETON WI 54912 - 627
Telephone Number 920-225-6507
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 inspe'ction is not performed within two business days from the time the project is ready.
"
J oh +I .6J-4 ~O (
City of Oshkosh
Division ofInspection 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.
· 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 YOU are a contractor participatinf;J in the Permit Fee Account System and have adequate funds. check here
if YOU want this processed throuf;Jh your account 0
DATE J--/~-() 7
JOB ADDRESS
OWNER
CONTRACTOR
So () s. tt) tilt c/ .S+.
Vtyr/ l-ClV/ /lJ/v(/-( 55
~W~1 rr ()yUU~1
/
~5S-0
~I tclhe
CHECK 0' ALL APPLICABLE
USE CATEGORY
DSingle Family
SERVICE DNew
o Change
o Temporary
ON ot Applicable
TYPE
~ommercial o Industrial
~g~~:~:~~und REeE1VE D
fEB 2 0 ')
o Duplex
DMulti-Family
DRental
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts
Phase
Amps
I
Receptacles #
Circuits # DEPARTMENT OF
FixturesCfPMMUNITY DEVELOPMENT
Switches #
CHECK 0' ALL APPLICABLE
DESCRIPTION OF ALL WORK BEING DONE
/\/ (i/J S-J.cw t'.
tv" Jilt VIer
DWater Heater l.9- ~
h
.~ tl'rJ
/;y \ .
ORange
DFan OR Blower
o Motors
DDishwasher
DFurnace
DGas Pumps
DGarbage Disposal
DAlC
o Other
DDryer
DElectric Sign
VAL UE (Including labor and all materials including light fixtures) $ J () I () or; , 00
MASTER ELECTRICIAN ~J 4. ~~ 7' )AI
Fee: $;)73,1)6
3/02