HomeMy WebLinkAbout0124405-Electric
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"'OSHKOSH
ON THE WATER
Job Address 2704 JACKSON ST
CITY OF OSHKOSH
No
124405
ELECTRIC PERMIT - APPLICATION AND RECORD
Service
b New
o Change 0 Temp
Owner HIS CHURCH WORLD OUTREACH INC Create Date 04/25/2007
Category 643 - Commercial-Addition/Remodels Plan
. N/A Type o Overhead o Underground
Circuits 3 Luminaires 10
--
Switches 6 Receptacles 18
Contractor
HIETPAS ELECTRIC
Volts
Amps
Appliances
r--
I
I
L_
Use/Nature of ICOM\, 0, ffice and, nurse,ry remodel
Work '
L; ":~~ "
!
\
Fees: Valuation
$3,700.00
Plan Approval _ $0.00
Permit Fee Paid
$111.00
Issued By:
!j'~~
Date 04/25/2007
o Permit Voided I
Parcelld # 1519600100
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
VYhile 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
N8619 COUNTY ROAD W
BERLIN
WI 54923 - 9433
Telephone Number 920-361-2020
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 ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1~30
Phone'(920) 236-5050
Fax (920) 236-5084
~
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 Services, PO Box 1128.
Oshkosh WI 54903-1128. Commencing work without perrnit(s) will result in fees being doubled or $100.00 plus the
nonnal permit fee. which ever is greater.
OR
[(YOU are a contractor participatinf! in the Permit Fee Account System and have adeouate funds. check here
if YOU want this processed throuf!h your account 0 . . .
DATE ?- 2s;c7
JOB ADDRESS *1 70 Y .J q (." 11 ~ 0 h ~ ff'<eJ--
OWNER . j,),~ 5 c ~ v r t: h '
CONTRACTOR I-iFf,;> {5/.,,~f;,~
CHECK Ii! ALL APPLICABLE
USE CATEGORY
OSingle Family DDuplex
OMulti-Family
ORental
9tommercial
DIndustrial
.SERVICE ONew
OChange
OTemporary
DNot Applicable
TYPE DOverhead
DUnderground
DNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
I
Receptacles #
l<{
(0
Circuits # 3 .
FixtUres # ) 0
. Volts
~hase
:Amps
Switches #
CHECK ~ ALL APPLICABLE
ORange
OFan OR Blower
OMotors
ODishwasher
OFurnace
DGas Pumps
DGarbage Disposal
DAle
o Other
ODryer DWater Heater
OElectric Sign
DESCRIPTION OF ALL WORK BEING DONE
Oft; ~ ~ .p q. wi
() UJ'~'6'Y'J
I
-
R~J.J
cO
. . VALUE (Including labor and aU materials including light iIXtures) $ "] I J 0 (j
MAsTERELECTRICIAN U~, ~-,.;J
3/02