HomeMy WebLinkAbout2011-Electric (low voltage) C .) CITY OF OSHKOSH No 146774
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 219 WASHINGTON AVE Owner DALE SCHOOL APARTMENTS INC Create Date 07/12/2011
Contractor ADT SECURITY SERVICES, 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
Amps Switches Receptacles
Appliances
Use /Nature of Low voltage / Cameras and access control equipment.
Work
Fees: Valuation $15,000.00 Plan Approval $0.00 Permit Fee Paid $249.00
Issued By: t / Date 07/12/2011
❑ Permit Voided Parcel Id # 0200930000
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 perm • Iication within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to se•0 .n. - . - . - arting such activity.
Signature % Date
Agent/Owner
Address 2500 N LYNNDALE DR APPLETON WI 54914 - 0 Telephone Number (920) 720 -6172
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 OfHKO /H
ON THE WATER
LOW VOLTAGE 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 a0i 143 )
JOB ADDRESS 2la \J\Do h 1 (€
OWNER PACk 1\ I 0 ��`l . l�Cl��1
CONTRACTOR ` E31 —
ELECTRICAL CONTRACTOR S U.) b o eL I L
(Locally Licensed Electrical Contractor conducting the associated power wiring)
CHECK El ALL APPLICABLE
USE CATEGORY
❑ Multi - Family (number of units ) Commercial ❑Industrial
CHECK 0 ALL APPLICABLE
cameras C� 1 on ❑Telephone 8 deo ❑White Noise Systems
❑ Data DSecurity ❑Television h ❑Voice
❑Fire Alarm ❑Sound Cdthe o t�� 'O
DESCRIPTION OF ALL WORK BEING DONE
0 )(iN xCtrs 0.,m 4cC-02 -6 -ki■- I P (` ��Me -u. \02.,� / c \ Nsko —W 1�
V
VALUE (Including labor and all mat Is for cable installation(s) $ \ f") (x, 00
APPLICANT SIGNATURE
08/09