HomeMy WebLinkAbout0157164-Electric (6 data ports) � CITY OF OSHKOSH No �s��sa
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2006-2020 JACKSON ST Owner 2020 JACKSON STREET LLC Create Date 08/12/2013
Contracto� CC&N Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause
Service � New � Change � Temp � N/A j Type � Overhead � Underground I
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances
Use/Nature of COMM\6 data ports
Work
I
I
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Fees: Valuation $400.00 Plan Approval $0.00 Permit Fee Paid $30.00
issued By: ( Date 08/12/2013
❑ Permit Voided� Parcel Id# 1514819800
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 N27W23588 PAUL RD _PEWAUKEE WI 53072 -5790 Telephone Number (262)523-3131
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.
08/09/2013 16:43 9208306725 CC&N PAGE 01/01
Ciry of Oshkosh
Division of Inspectioa Services �
�.O-�ox 1130 �
Oshkosh WI54903-1130
Phone(920)236-5050
Fax (920)236-5084 O�K�J�--�
oN?HF. WAiF.R
ELECTRICAL PERMIT APPLICATION
All information a8er bold categories nau,at bc provided.
Incomplete applicariona will not be pr+oce.vsed.
• Application(s)and fee{s)can be brought to City Hall,Room 205 or mailed to Jnspcetion Sezviees, p0 Box l 128,
Oshkosh WI 54903-11z8. Comn�emcing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit f�e,which ever is grcatcr.
OR
�f vou are a contractor particina�inp in 1he Permit Fee Account Svstem and have adeauate f�_ch ck e e
if vou want this rocessed through �ur accnunt ❑
�p-o�oat� JaLl�son S�r AA'� 8/9/2013
JOB A.DA�iESS 2010 Jac�tso�n Street �6�1* ��>
OWNER-Edward Jones_(Ta�stalLCustor�n Provided Material)
CONTRACTOR CCRsN
CHECK�,A,�L A.PPLICA,l3LE
USE CATEGORY
❑Single Family C1Duplex ❑Multi-Faznily ❑Rental X Commercial ❑�adustzial
SERVTCE ONew �Tezx�porary '�'�'�E ❑Overhea.d �Not Applicable
�Chat�ge C7Not A,pplicabl.e �Undcrgrouud ClUndezground
F�L�N THE A,PPROPR�A,TE BL,ANK W�'�'H TSE NUMSER
Volts / Receptacles#61ow volt data Circuits#
Pb�ase
Amps Switches# �'��tu�#___________
CHECK Bf ALL APPLICABLE
ClRangc ❑I3ishwasher ❑Garbage Ai.sposal. ODryez ❑Wate.r Heater
❑Fan OR Blower OFumace ❑.4/C ❑Electric Sign
OMotors ❑Gas Pumps �Other Aata cable installation
DESC.RTPTIO�T OF A.LL WORK BEING DONE -Insts�lled enstomer��rnv�ded data cable to(� �acat�ops .
Within the su�te. Job#8�1199C
VALTJ�(Tncludin�labor and s11 nnatenisls including light fixture.q) $400.00 Fee amount-$�5.00
LOW VOLTA,GE DESIGNERlPM -Donsld G Tol�er
3/02