HomeMy WebLinkAbout0154757-Electric (low voltage) /�"� CITY OF OSHKOSH No 154757
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1828-1900 JACKSON ST Owner FAIR ACRES LLC/MAJERS LLC Create Date 03/19/2013
Contractor GOVERT TELECOM SERVICES LLC Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause
Service New � Change � Temp � N/A � Type � Overhead � Underground �
Volts _ Circuits Luminaires
Amps Switches Receptacles '
APPliances .
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Use/Nature of OMM(1828-HOMETOWN PHARMACY)/INSTALL(8)VOICE/DATA CAT 5E WIRES *"check#2065 I
Work I !,
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Fees: Valuation $600.00 Plan Approval $0.00 Permit Fee Paid $38.00
Issued By: c�� Date 03/19/2013
❑ Permit Voided ! Parcel Id# 1514970200
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
AgenUOwner ,
Address 10130 S COUNTY ROAD H BELOIT WI 53511 -9618 Telephone Number (608)365-9552
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 (420)236-5084 HK I I
ON THE WATFR
LOW VOLTAGE ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applicadons 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
l�vou are a contractor participating in the Permit Fee Account Svstem and have adequate funds check here
if vou want �his processed through vour accounl ❑
DATE � Z _�
JOB ADDRESS Z b T
OWNER C � '—
CONTRACTOR (��[/c'2T /�.��E�o�n .�.1c�Zr/«c"3", LL�
ELECTRICAL CONTRACTOR
(Locally Licensed Electrical Contractor conducting the associated power wiring)
CHECK�ALL APPLICABLE �
USE CATEGORY
❑Multi-Family(number of units ) [B"Commercial ❑Industrial
CHECK�ALL APPLICABLE
❑C�rreras ❑Motion �Telephone OVi�eo ❑White Noise Systems
[I]'�ata OSecurity ❑Tetevision �ice
❑Fire Alarm ❑Sound ❑Other
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DESCRIPTION OF ALL WORK BEING DONE��t/S�LL I�,�C� l�i5l"l9� ��C
L�/2 C��
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VALUE(Including labor and all materials tor cable installation(s) $ (O�� -�d
APPLICANT SIGNATURE
� OB/09