HomeMy WebLinkAbout0153809 - Electric (install circuits, lights etc) (1) CITY OF OSHKOSH No 153809
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 100 C CITY CENTER Owner CITY CENTER ASSOCIATES LLC Create Date 12/04/2012
Contractor MY ELECTRIC CORP Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause -
Service 0 New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches _ Receptacles
Appliances
Use/Nature of COMM(PLANET PERK)/INSTALL CIRCUITS, LIGHTS,SWITCHES AND RECEPTACLES **check#18871
Work
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: B U✓ Date 12/04/2012
ri Permit Voided J Parcel Id# 0100600000
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 6012 KOELPIN RD OSHKOSH WI 54902 -9117 Telephone Number (920)231-0707 _
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 OJHKOIH
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 12/4
JOB ADDRESS 100 City Ctr
OWNER Planet Perk
CONTRACTORMY Electric Corp.
CHECK H ALL APPLICABLE
USE CATEGORY
(Single Family (Duplex ERental Commercial 'Industrial
SERVICE ❑New nTemporary TYPE ❑Overhead ❑Not Applicable
❑Change [Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts I Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK®ALL APPLICABLE
['Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ['Water Heater
❑Fan OR Blower ['Furnace ❑A/C ❑Electric Sign
[—Motors ( IGas Pumps nOther
DESCRIPTION OF ALL WORK BEING DONE
Installation of circuits, lights, switches, rcpt's.
VALUE(Including labor and all materials including light fixtures) $500.00
MASTER ELECTRICIAN
3/02