HomeMy WebLinkAbout0124103-Electric (phone/cable jacks)
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OSHKOSH
ON THE WATER
CITY OF OSHKOSH
No
124103
ELECTRIC PERMIT - APPLICATION AND RECORD
Service
b New
o Change
o Temp
. N/A
Type 0 Overhead
C leate Date ,04/05/2007
Plan
o I Underground
ILl . .
, ummalres
keceptac,es
Contractor
3121 ELK RIDGE DR
ACCU-COM
Owner
MIDWEST GENERAL CONTRACTORS
Job Address
Category 631 - Residential-New Multi-Family Wiring
Volts
Circuits
Fees: Valuati
, ,
Low voltage - install phone & cable jacks. ""DEBIT ACCr".
on $4 480.00 Plan roval $0.00 Permit Fee Paid $128.0
Switches
Amps
Appliances
Use/Nature of
Work
Issued By:
I~ Date 04/05/2007
o Permit Voided I 1arcelld # 1329600000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction. l
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the wo k
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easeme~t
holder(s) and to secure any necessary approvals before starting such activity.
Signature
App
~
Date
AgenUOwner
Address
1218 OSHKOSH AVE
OSHKOSH
WI 54902 - 0
Telephone Number
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Perm~t Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), yoli.r Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is recbived. Work may
continue if the inspection is not performed within two business days from the time the project is read~.
I
City of Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone"(920) 236-5050
Fax (920) 236-5084
I~
J"
OJHKOfH
ON THF WATER
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 Servil es, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being dOllIed or $100.00 plus the
normal pennit fee, which ever is greater.
. ..'
()It " . . "
[fvou are a contractor DarticiDating in the Permit Fee Account Svstem and have adequ te funds. check here
ifvou want this processed throu.h vour account 0 . DATE 'i Lrli.\)\
JOBADDRESS.S \Lf Elk 721'J.~ l I
OWNER. M. ~"Jv~ f/.a ~ ( + '1 .
.. CO~CTOR (t-c<:-v- --(Q J .
CHECK Ia ALL APPUCABLE
USE CATEGORY
DSingle Family
ODuplex
qg~amilY
DRental
TYPE
o Commercial I DIndustrial
DOverhead DNot Applicable
OUnderground
..SERVICE DNew
DChange
DTemporary
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
. V rilts
:phase
~ps
I
Receptacles #
Circuits #
Switches #
Fixtures #
CHECK It'J ALL APPLICABLE
ORange
OFan OR Blower
OMotors
ODishwasher
OFumace
OGas Pumps
DGarbage Disposal
DAlC
DOther
p ~ 'O"-L C c-.l:;1 <L
DDryer. Water Heater
DElectric Sign
DESCRIPTION OF ALL WORK BEING DONE
Jet (ts
I
. " VALUE (Including labor and all materials including light fixtures) $ 1,-, Y r 0
o'b-
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MAsTER ELECTRICIAN
3/02