HomeMy WebLinkAbout0155813-Electric (service) � CITY OF OSHKOSH No 155813
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 490 N CAMPBELL RD Owner WIS PUBLIC SERVICE CORP Create Date 05/22/2013
Contractor NORTHLAND ELECTRICAL SERVICES L Category 644-Commercial-Service Change Plan
Inspector Adam Krause
Service New � Change 0 Temp 0 N/A Type � Overhead � Underground I .
Volts 120/208 Circuits Luminaires
Amps 400 Switches Receptacles
Appliances ,
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Use/Nature of OMM(TIME WARNER CABLE)/UPGRADE SERVICE AND GENERATOR SYSTEM "'check#30076, 30105 �,
Work :
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Fees: Valuation $100,000.00 Plan Approval $0.00 Permit Fee Paid $563.00
Issued By: ��� Date 05/24/2013
❑ Permit Voided I Parcel Id# 1608710200
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 1100 ORVILLE DR _ NEW LONDON WI 54961 -9418 Telephone Number (920)531-1197
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, W( 54903-1130
Phone(920)236-5050
Fax (920)236-5084 n r�--�KOf H
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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 1 128,
Oshkosh WI 54903-1 128. Commencing work without permit(s) will result in fees being doubled or$100.00 plus the
normal permit fee, which ever is greater.
OR
/f vou a�•e a contrac[o�� parlicipating in the Pe►-mi1 Fee Accoun[ Svstem and have ndequate rtrnds, check here
if vou wanl this processed Ihrough your account ❑
DATE rI
JOB ADDRESS � I �
-�- 1 �� RECEIVED
OWNER r �
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�y I
CONTRACTOR ' � 1 ' , ���� MAY 2 0 2013
CHECK 0 ALL APPL[CABLE DEPARTI�9E\TOF
CO�t�4U\TfY DEVELOP1fEVT
iNSPECTiOti SERVICES Dl�'IS10V
USE CATEGORY
OSingle Family ❑Duplex ❑Multi-Family ❑Rental �Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
,�Change ❑Not Applicable �Underground
FILL IN THE APPROPRIATE I3LANK W[TH THE NUMBER
Volts Za / �� Receptacles # Circuits #
Phase �" � j � j ( � ��
Amps �-400 Switches # Fixtures #
CHECK 0 ALL APPLICABLE
❑Range ❑Dishwasher ❑Garba�e Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C �Electric Sign �
❑Motors ❑Gas Pumps f�Other ��,��z�a�d�
DESCRIPTIUIV OF ALL WOR EING UONE (
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VALU� (Including labor and all materials including light fixtures) $ �'ia� k,
MASTER ELECTRICIAN��I 11 1 t )�Il�l
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