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OSHKOSH
ON THE WATER
Job Address 3151 ELK RIDGE DR
CITY OF OSHKOSH
No
124105
ELECTRIC PERMIT -APPLICATION AND RECORD j
Owner MIDWEST GENERAL CONTRACTORSreate Date
04/05/2007
Contractor
ACCU-COM
b New
Category 631 - Residential-New Multi-Family Wiring Pan
Service
o Change 0 Temp
. N/A
Type
Overhead
i Underground
Volts
Circuits
Luminaires
Amps
Switches
Receptacles
Appliances
Use/Nature of Low voltage - install phone & cable jacks. --DEBIT ACCT--.
Work
Fees: Valuation
$128.do
I~ Date 04/05/2007
o Permit Voided I farcelld # 1329600000
In the performance of this work I agree to perform all work pursuant to rules goveming the described construction. I
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the w~rk
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
$4,480.00
~
Plan Approval
$0.00
Permit Fee Paid
Issued By:
Date
Address
1218 OSHKOSH AVE
Agent/Owner
OSHKOSH
WI 54902 - 0
Telephone Number
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, permlt 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 rec~ived. 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 54903-1 qo
Phone'(920) 236-5050
Fax (920) 236-5084
~
I)fHKOfH
ON THF W^TER
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 permit(s) will result in fees being douBled or $100.00 plus the
normal permit fee, which ever is greater.
OR
Ifvou are a contractor DarticiDating in the Permit Fee Account Svstem and have adequ!ate funds. check here
ifvou want this Drocessed throuf!h vDur account 0,' I."
. ' . ( . DATE l/t/:)? r!J 7
JOB ADDRESS ~ 1 s-) .r; If Rr JjL
oWNERfi1lJ~u fZc ~~ .
. CONTRACTOR Ace 1)- (, G~
CHECK ~ ALL APPLICABLE
USE CATEGORY
DSingle Family DDuplex
. SERVICE DNew. DTemponuy
DChange DNot Applicable
~~-FamilY
DRental
o Commercial
DIndustrial
TYPE DOverhead
OUnderground
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
. Volts
:phase
Amps
/
Receptacles #
Circuits #
Switches #
FixtUres #
CHECK ~ ALL APPLICABLE
ORange ODishwasher DGarbage Disposal
OFan OR Blower OFurnace DAlC
OMotors DGas Pumps DOther
DESCRIPTION OF ALL WORK BEING nONE f ~ b V'- C Ci.~ Ie
DDryer ! Water Heater
DElectric Sign
T tider
. 0
. . VALUE (Including labor and all materials including light fixtures) $ tf. erg 0 "E--.
MASTER ELECTRICIAN
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