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OSHKOSH
ON THE WATER
Job Address 400-410 S KOELLER ST
CITY OF OSHKOSH
No
126919
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
GROWTH MOTELS OSHKOSH/L D ENGEL! Create Date 09/24/2007
Contractor
WERGEDAL SKOGSTAD ELECTRIC INC
Category 642 - Commercial-New Building Wiring
Plan
Service
b New
o Change 0 Temp
. N/A
Type 0 Overhead
o Underground
Volts
Circuits
Luminaires
Amps
Switches
Receptacles
Appliances
Use/Nature of New 80 Unit 4 Story Comfort Inn Hotel* Installation to include the installation of the phone, CATV, Fire Alarm, Data, Internet cabling.
Work ermination is by others.
Foes' va]u~. $405,000,00
Issued By: ~
Plan Approval $0.00
Permit Fee Paid
$1,428.00
Date 09/24/2007
o Permit Voided I
Parcelld #0611630100
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshko ha no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this per It ap' catio within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to s any a provals bet: st ing such activity. _ /~
Signature a~ Date ~7
I '
Address
FALL CREEK WI 54742 - 67
Telephone Number (715) 877-3177
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 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
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ON THF WATFR
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 vou are a contractor participating in the Permit Fee Account Svstem and have adequate funds. check here
if vou want this vrocessed through vour account 0
JOB ADDRESS
OWNER
CONTRACTOR vUe~yed(,lj SJ(09'~ .f-pA f{('rAi( J7iJc,
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DATE . q/~'I/a 7
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CHECK It:1 ALL APPLICABLE
USE CATEGORY
DSingle Family
SERVICE ~ew
OChange
DDuplex
DMulti-Family
DRental ~ommercial Dlndustrial
TYPE OOverhead ONot Applicable
~nderground
o Temporary
ONot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
V oIts
Phase
Amps
/2.0 I :zol?
_3
:?-o (')CJ
Receptacles #
Circuits #
Switches #
Fixtures #
CHECK It:1 ALL APPLICABLE
ORange
OFan OR Blower
DMotors
ODishwasher
OFurnace
DGas Pumps
OGarbage Disposal
OAlC
D Other
ODryer OWater Heater
OElectric Sign
DESCRI~TION OF ALL WORK BEING DONE
I. /
Nf'Vt.1
(C)/'r1-AA T L(l,
&Jt/~f
L"" -1 w72( .
VALUE (Including labor and all materials including light fixtures) $ $~.fCIOO ( CJ ()
MASTER ELECTRICIAN RuJ.J. I/Jery eti (J.j
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3/02