HomeMy WebLinkAbout0146584-Electric C .) CITY OF OSHKOSH No 146584
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2580 W 9TH AVE Owner CALVARY LUTHERAN CHURCH Create Date 06/28/2011
Contractor YOURR ELECTRIC 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 4
Amps Switches 2 Receptacles 8
Appliances
Use /Nature of COMM / INTERIOR ALTERATION TO INCLUDE ADDING (2) OFFICES * *check #3689
Work
Fees: Valuation $1,740.00 Plan Approval $0.00 Permit Fee Paid $77.00
Issued By: Date 06/28/2011
❑ Permit Voided I Parcel Id # 0613600000
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 n easement, the City strongly urges the permit applicant to contact the easement
holder(s) a e any necesgary< ro is before starting such activity.
Signature / 6 t
Da _
Agent/Owner
Address PO BOX 311 DALE WI 54931 - 311 Telephone Number (920) 779 -6989
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
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 OJHKOJH
ON THE 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 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 participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account ❑
DATE /acid
JOB ADDRESS as o �4
OWNER _ - -111-euA ck
CONTRACTOR l9L dVV t L.-LC
CHECK gi ALL APPLICABLE
USE CATEGORY
El Single Family ❑Duplex ❑Multi - Family ❑Rental ercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE El Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # Circuits #
Phase
Amps Switches # Fixtures #
CHECK Eli ALL APPLICABLE
❑ Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑ Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑ Motors ❑Gas Pumps ❑Other
DES -2 1' TION OF ALL W = B ING D f NE � ► /L� ` 1.A I St �g
VALUE (Including labor and : mat'rials inclu • g light fixtures) $
MASTER ELECTRICIAN
3/02