HomeMy WebLinkAbout0156141-Electric (fire pump) � CITY OF OSHKOSH No 156141
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3450 N MAIN ST Owner CURWOOD INC Create Date 06/11/2013
Contractor NORTHLAND ELECTRICAL SERVICES L Category 653-Industrial-Addition/Remodels Plan
Inspector Adam Krause
Service ,� New 0 Change � Temp � N/A Type � Overhead � Underground
Volts 120/208 Circuits Luminaires
Amps 200 Switches Receptacles
Appliances
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Use/Nature of IND\Fire pump
Work
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Fees: Valuation $20,000.00 Plan Approval $0.00 Permit Fee Paid $283.00
Issued By: �� Date O6/12/2013
❑ Permit Voided'� Parcel Id# 1519603300
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 1100 ORVILLE DR NEW�ONDON 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
co�tinue 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
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Fax (920)236-5084 �� H
ELECTRICAL PERMIT APPLICATION D
All information after bold categories must be provided.
Incomplete applications will not be processed. �UN 1 2 2013
• Application(s)and fee(s)can be brought to City Hall, Room 205 or mailed to Inspection Services,���r28�
Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being d���b.��e�'����'
� ' R�'iC . Dl�'ISIQ'V
normal permit fee,which ever is greater.
OR
I�vou are a contractor participatinQ in the Permit Fee Account Svstem and have adeguate funds, check here
�You want this processed throuQh vour account ❑
� �S Q DATE � � �
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JOB ADDRESS ' T�P�
OWNER P(� �
CONTRACTOR V`ca r�:�c°S IV2u� ��°'''
CHECK L�f ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex ❑Multi-Family �Rental ❑Commercial �,Industrial :
SERVICE ❑New ❑Temporary TYPE ❑Overhead l�'Not Applicable
❑Change ,�Not Applicable �Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts Receptacles# � Circuits#�_
Phase L,/
Amps Switches# Fixtures# �
CHECK 0 ALL APPLICABLE
❑Range ODishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
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DESCRI ION OF ALL WORK BEING DONE I o 0. c � �
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VALUE(Including labor and all mate ls includin li t fixtures)$ �.��� :
MASTER ELECTRICIAN
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