HomeMy WebLinkAbout0156974-Electric (receptacles & outlets) /�', CITY OF OSHKOSH No 156974
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1925 JACKSON ST Owner JACOBSON AUTOMOTIVE HOLDINGS LLC Create Date 07/30/2013
Contractor SLIM'S ELECTRIC INC Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause
Service New � Change � Temp � N/A Type � Overhead 0 Underground
Volts 220 Circuits 2 Luminaires
Amps Switches Receptacles 2
Appliances
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Use/Nature of OMM/ADD(2)RECEPTACLES ON(2)CIRCUITS *'check#5153
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Work
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Fees: Valuat' n $500.00 Plan Approval $0.00 Permit Fee Paid $30.00
Issued By: Date 07/30/2013
❑ Permit Voided I Parcel Id# 1218920000
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 2608 OAKWOOD CIR OSHKOSH WI 54904 -8466 Telephone Number (920)426-5249
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.
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
Phone (920) 236-5050 '
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.
If you are a contractor participating in the Permit Fee Account System
and have adequate funds, type ___ if you want this processed through
your account
DATE 07/25/2013
JOB ADDRESS 1925 Jackson Dr
OWNER
CONTRACTOR SLIM'S ELECTRIC INC.
CHECK ALL APPLICABLE
USE CATEGORY Single Family Duplex Multi-Family Rental
X Commercial Industrial
SERVICE New Tem ora T�E Not
p �' Overhead Applicable
Not
Change Applicable Underground
FILL IN THE APPROPRIATE BLANR WITH THE NUI�ER
Volts 220 Receptacl� 2 Circuits# 2
Phase 1
Amps 30 Switches# ; Fiztures# ,
CHECK ALL APPLICABLE
Range Dishwasher Dispo abage Dryer Heaterater
Fan OR Furnace p/C Electric
Blower Sign
Motors P�ps S Other
DESCRIPTION OF ALL WORR BEING DONE VALUE.
(Including labor and all materials including light fixtures)
Add 2 rec' s on 2 circ . $ 500. 00
MASTER ELECTRICIAN � C�" `
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