HomeMy WebLinkAbout0145996-Electric I CITY OF OSHKOSH No 145996
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 103 ALGOMA BLVD Owner ONE SIX EIGHT ENTERPRISE LLC Create Date 05/20/2011
Contractor HELMER ELECTRIC INC Category 643 - Commercial- Addition /Remodels Plan
Inspector Kevin Benner
Service 0 New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits Luminaires 1
Amps Switches 1 Receptacles 1
Appliances
Use /Nature of COMM / Bathroom remodel.
Work
Fees: Valuation $490.000 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: ,, . Date 05/20/2011
❑ Permit Voided Parcel Id # 0100950000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While 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 W3547 HILLSIDE CIR MALONE WI 53049 - 1689 Telephone Number (920) 922 -2270
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 of Inspection Services j
P.O. Box
Oshkosh, W1 WI 54903 -1130
11)111r
Phone (920) 236 -5050
Fax (920) 236 -5084 C) I IKO/ I
ON THE WATFR
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applicaticns will not be processed.
• Application(s) and fee(s) can be brought to City Hall, oom 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 you are a contractor narticipatintr in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account 0 I
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JOB ADDRESS I Di I IBC)rrfz. ISIVk-
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OWNER k a P 1 . fi a � _° _ f
CONTRACTOR -- Ve\ r 1 Lax-11 .'' C -. MAY 2 0 2 011
DEPARTMENT OF
CHECK ® ALL APPLICABLE COMMUNITY DEVELOPMENT
USE CATEGORY NSPECTION SERVICES DIVISION
❑Single Family ❑Duplex ❑Multi - Family ❑Rental Commercial ❑Industrial
SERVICE ❑New ❑Temporary ! TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE MBER
Volts / Receptacles # / Circuits #
Phase
Amps Switches # Fixtures #
CHECK ® ALL APPLICABLE
❑' • - ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
'= • R Blower ❑Furnace ❑A/ ❑Electric Sign
❑Motors ❑ Gas Pumps ❑ Other
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all material • . c . '■'g • fix . d)
MASTER ELECTRICIAN /
3/02