HomeMy WebLinkAbout2013-Electric (build out) . � �
� CITY OF OSHKOSH No 15 s�
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1210-1226 S KOELLER ST Owner 1200 SOUTH KOELLER STREET IV LLC Create Date 08/16 013
Contractor HULLAR ELECTRIC LLC Category 642-Commercial-New Building Wiring Plan
Inspector Adam Krause
Service New Q Change Q Temp Q N/A Type Q Overhead � Underground
Volts 120/200 Circuits 15 Luminalres 20
Amps 200 Switches 10 Receptacles 35
Appliances �
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Use/Nature of OM(1210)/BUILD OUT FOR DOCTORS OFFICE "check#3575
Work
Fees: Valuation $10,500.00 Plan Approval $0.00 Pennit Fee Paid $229.00
Issued By: �� Date 08/1 013
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� Permit Voided� Parcel Id# 13084 403
In the perfortnaAce of this work I agree to perform ail wo�ic pursuant to rules goveming the described construction.
While the City 4f Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in thi�permk application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to',secur sary appro ore starting such activiry.
Signature ' Date
' AgenUOwner
Address 2535 KNAPP ST OSHK03H WI 54902 .9004 Telephone Number 920 233-3667
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To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type
Inspection(i.e.Footing,Service,Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Ph e
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,WI54903-1130
Phone(920)236-5050 01HK01H
Fax (920)236-5084 �
ON THF WATFR
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$100.00 plus the
normal permit fee,which ever is greater.
OR
If vou are a contractor participating in the Permit Fee Account Svstem and have adeguate 1'i�nds, check here
if vou want this processed throu�h vour account ❑
DATE� � I G, ;�l
JOB ADDRESS �2,I C� �"�c�I;
OWNER
CONTRACTOR �/lwr ��tc{�,c
CHECK 0 ALL APPLICABLE
USE CATEGORY '
❑Single Family ❑Duplex ❑Multi-Family ❑Rental �ercial ❑Industrial '
SERVICE �1ew ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable �derground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / 2 J 5 Receptacles#� Circuits#�
Phase
Amps �C� G Switches# �� Fixtures#��
CHECK E�f ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE Q v�� / �".��s- �JC �r
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VALUE(Including labor and all materials including light fixtures)$ �-i'I�� S�• �
MASTER ELECTRICIAN � /
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3/02
�✓� 3575