HomeMy WebLinkAbout0099889-Electric (elevators)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
855 N WESTHAVEN DR
STAFF ELECTRIC CO
[~ New (~) Change (~) Temp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner AURORA MEDICAL GROUP INC
Category 643- Commercial-Addition/Remodels
Type I~ Overhead
Circuits 0
Switches 0
No 99889
Create Date 02/12/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of Aurora Hospital / Power wiring associated with the elevators
Work
Fees: Valuation
Issued By:
$13,500.00 Plan Approval
$0.00 Permit Fee Paid
$192.00
Date 02/20/2003
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address PO BOX 917 BUTLER WI 53007 - 917 Telephone Number
262-781-8230
Job % 18771
Pr~j Mg?~ M. Lochmann
Jeff R.
~i~uO~c~fAIv~nSPu~Ction Services ~, ?~ ·
P.O. Box 1130 m~--~i '~
'Incomp la're app 1 lost loss' ' will' ~t be p roses zed . ' ~'~ . t~ r~ ~ ~
CONTRACTOR Staff EleCtric CO Inc
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY
SERVICE NEW CHANGE
TYPE OVERHEAD UNDERGROUND
NO. OF FIXTURES SWITCHES
AMPS VOLTS /
DUPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
TEMPORARY NOT APPLICABLE
NOT APPLICABLE
RECEPTACLES CIRCUITS
PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL DRYER
DISHWASHER FAN OR BLOWER FURNACE A/C
ELECTRIC SIGN MOTORS GAS PUMPS OTHER X
DESCRIPTION OF ALL WORK BEING DONE
· Submit payment with application. Failure to pay within 30 days will resul~ in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater, x i~ ~
VALUE (Including labor and all materials including light f~
MASTER ELECTRICIAN