HomeMy WebLinkAbout0124725-Electric (exhaust fan-trauma area)
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OSHKOSH
ON THE WATER
Job Address 855 N WESTHAVEN DR
CITY OF OSHKOSH
No
124725
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
AURORA MEDICAL CENTER OF OSHKOSI Create Date 05/10/2007
Contractor
STAFF ELECTRIC CO INC
Category 643 - Commercial-Addition/Remodels
Plan
o New
o Change 0 Temp
. N/A
Type 0 Overhead
o Underground
Service
Volts
Circuits
Luminaires
Amps
Switches
Receptacles
Appliances EXHAUST FAN
Use/Nature of COMM / WIRE AN EXHAUST FAN IN THE ER TRAUMA AREA
Work I
Fees: Valuation $3,000.00
Issued By: 7Jyy) lA.)
Plan Approval
$0.00
Permit Fee Paid
$94.00
Date 05/10/2007
o Permit Voided I
Parcelld # 1621520000
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
PO BOX 917
BUTLER
WI 53007 - 917
Telephone Number 262-781-8230
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.
Electric Permit Work Card
Job Address 855 N WESTHAVEN DR Permit Number 124725
Create Date 5/10/2007
Owner AURORA MEDICAL CENTER OF OSHKOSH
Service b New 0 ChangeO Temp . N/A
Volts Circuits
Contractor STAFF ELECTRIC CO INC
I Type 0 Overhead 0 Underground . N/A
Luminaires
Value
.Amps
Switches
Receptacles
$3,000.00
Use/Nature 543 - Commercial-Addition/Remodels COMM / WIRE AN EXHAUST FAN IN THE ER TRAUMA AREA
of Work
Inspections:
Date 08/03/2007
Type Final
Inspector Kevin Benner
no time
REQUEST LINE / READY FOR A FINAL INSPECTION
DatelTime requested: 07/31/2007 11:40 AM Notice Type:
Access: Anyone from the facility can show you were the fan is
Requested by: STAFF ELECTRIC CO INC - Steve
o Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
Ready DatelTime: 07/31/2007 11 :40 AM
Phone Number: (414) 588-5005
Job # 114883 Proj Mgr; M. Lochmann Jeff R.
~
OJI-KOJR
ON THE WATER'
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
Phone (920) 236-5046
RECEIVED
MAY 9 2007
. DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
5-8-07
DATE
JOB ADDRESS
Aurora / Oskosh
855 N.Westhaven Dr
Oskosh, Wi 54904
OWNER
CONTRACTOR Staff Electric Co Inc
---B8t~g0,9W1 53007-0917
CIRCLE ALL APPLICABLE
RENTAL ~~ INDUSTRIAL
USE CATEGORY SINGLE FAMILY DUPLEX MULTI-FAMILY
SERVICE
NEW
CHANGE
TEMPORARY
NOT APPLICABLE
TYPE
. OVERHEAD
UNDERGROUND
NOT APPLICABLE
NO. OF FIXTURES
SWITCHES
RECEPTACLES
CIRCUITS
AMPS
VOLTS
/
PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATER
GARBAGE DISPOSAL
DRYER
DISHWASHER FAN OR BLOWER
FURNACE
A/C_
ELECTRIC SIGN_
MOTORS
GAS PUMPS
OTHER
DESCRIPTION OF ALL WORK
.....-:r
1Z~"\~ f.
.-o:r'.. y. A'v..--"" ,,~ ~ G. c...
. Submit payment with application. Failure to pay within 30 days will result. in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
$75.00
VALUE
(Incl",U~g labor #: ma.:erialS . ;.nclU~ing Hght fixtures) $ 3.000.00
ELECTRICIAN i...... c4 'R /~
)
MASTER
~~ 1{ll\:-53\- 0.-573