HomeMy WebLinkAbout0154053 - Electric (new dispensers) CITY OF OSHKOSH No 154053
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3700 JACKSON ST Owner OSHKOSH PANTRY 41 LLC Create Date 12/20/2012
Contractor TOTAL MECHANICAL INC Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause
Service 0 New 0 Change 0 Temp • N/A Type O Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances 11Gas Pumps
Use/Nature of COMM/DISCONNECT(4)DISPENSER&WIRE(4)NEW DISPENSERS USING THE EXISTING WIRE **check#139315
Work
Fees: Valuation $2,170.00 Plan Approval $0.00 Permit Fee Paid $94.00
Issued By: anitki Date 01/02/2013
Permit Voided Parcel Id# 1527180000
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 W234N2830 PAUL RD PEWAUKEE WI 53072 -5731 Telephone Number (262)523-2500
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 oOofInsh
Division ision of Inspection Services
P.O.Box 1130
(11111-16-")
Oshkosh, WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 OJHKOJH
ON THE 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 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 /d J`7-J
JOB ADDRESS `3 9 CO ,!L cksvn _5f
OWNER Rr
CONTRACTOR 7;Q1 Jre 1111 ni Ca l / 1..m. e- •
CHECK C•d ALL APPLICABLE
USE CATEGORY �
0 Single Family ODuplex ❑Multi-Family ❑Rental IEJCommercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ITXot Applicable
❑Change C2iot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK El.ALL APPLICABLE
ORange ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
DFan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors C ias Pumps El Other
DESCRIPTION OF ALL WORK BEING DONE 171.5 e4n ii�r O cif y_t'�JIJ-' -
I2trL (4) 1'1ei,D CJiSpL LSe/.S uS// 19 4110 P xi-/,S/1r N.vil'e._
VALUE (Including labor and all m ials including light fixtures) $ dl /7d. 00 MASTER ELECTRICIAN ..- A
3/02