HomeMy WebLinkAbout0124104-Electric (low voltage)
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OSHKOSH
ON THE WATER
Job Address 3190 WHITE TAIL LN
CITY OF OSHKOSH
No 124104
Service
b New
o Change
o Temp
. N/A
Type 0 Overhead
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c'reate Date 04/05/2007
p~an
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o Underground
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, ummalres
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:Receptacles
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ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
MIDWEST GENERAL CONTRACTORS
Contractor ACCU-COM
Category 631 - Residential-New Multi-Family Wiring
Volts
Circuits
Amps
Switches
Appliances
Use/Nature of Low voltage - install phone & cable jacks. ""DEBIT ACCT"".
Work
Fees: Valuation
$3,840.00
Plan Approval
$0.00
Permit Fee Paid
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$111.00
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Issued By:
~
o Permit Voided I
Agent/Owner
Address
1218 OSHKOSH AVE
OSHKOSH
WI 54902 - 0
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To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, perJit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), yo~r Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is re4eived. Work may
continue if the inspection is not performed within two business days from the time the project is readt.
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OJHKOfH
, ON THF WATER
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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 Servi~, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being doubled or $100.00 plus the
nonnal permit fee, which ever is greater. ,I, .' ,
OR . 'I
Ifvou are a contractor particiDating in the Permit Fee Account Svstem and have adeaubte funds. check here
ifvou wont this Drocessea through vour accaunt 0 DATE '-/?! 1) 7
JOB ADDRESS~ C1 0 ~\l+- '\-~'~ \ ! '
OWNER l\" J:.;:t 'r. ~ "'- \ -\ 7 :
CONTRACTOR \A.-c '- V -- (Q fV" i
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DRental DCommercial i Dfudustrial
TYPE DOverhead DNO~ Applicable
DUnderground i
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oDryerdwater Heater
DElectric Sign I'
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~tdlcs
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI54903-1130
Phone'(920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
CHECK fa ALL APPLICABLE
USE CATEGORY
DSingle Family
DDuplex
~-Family
,'SERVICE DNew
DChange
DTemporary
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
, Volts
:rhase
Amps
Circuits #
Receptacles #
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Switches #
Fixtures #
CHECK fa ALL APPLICABLE
ORange
OFan OR Blower
OMotors
ODishwasher
OFumace
OGas Pumps
DGarbage Disposal
DAlC
DOther
DESCRIPTION OF ALL WORK BEING DONE
~~~N-. / C~h I (.
{
'"'?, oU 0, ,0 ()
, , ' VALUE (Including labor and all materials including light llXtures) $ ~?) L
MASTER ELECTRICIAN
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3/02