HomeMy WebLinkAbout0133583-Electric (elevator)OSHKOSH
ON THE WATER
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
Job Address 631 HAZEL ST Owner HEALTH CARE REIT INC
Contractor SUBURBAN ELECTRICAL ENGINEERING Category 643 -Commercial-Addition/Remodels
Service New Q Change Q Temp ~ N/A Type Q_Overhead
Volts Circuits
Amps Switches
Appliances
Use/Nature of
Work
/Wire up new elevator.
Fees: Valuation /~ $500.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: (/l.~~~y(~
Permit Voided
Date 1.0/20/2008
Parcel Id # 1103740000
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 709 N HICKORY FARM LN APPLETON WI 54914 - 3032 Telephone Number (920) 739-5156
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.
No 133583
Create Date 10/20/2008_
Plan
Q Underground
Luminaires
Receptacles
~~~ ~~~
City of Oshkosh ,- ,. r -:
Division of Inspection Services ~~ (~ ~ ~ `' ~''i~'' f'~
P.O. Box 1130 ,:
Oshkosh, WI 54903-1130
Phone (920)236-5050
Fax (920)236-5084
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 you are a contractor narticinating in the Permit Fee Account Svstem and have adequate funds, check here
if you want this processed through your account ^
Receptacles #
JOB ADDRESS~~-~LP/ r~lT.
OWNER ~!J'C- 1 ~ ~ UL~(l~,(J
CONTRACTOR <<Yl~/~/~ ~~~~CJ
CHECK D ALL APPLICABLE
USE CATEGORY
^Single Family ^Duplex ^Multi-Family ^Rental ~ICommercial ^Industrial
SERVICE ^New ^Temporary TYPE ^Overhead ^Not Applicable
^Change ^Not Applicable ^Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts ,
Phase
Amps
Switches #
DATE /' ~
Circuits #
Fixtures #
CHECK Q ALL APPLICABLE
^Range ^Dishwasher
^Fan OR Blower ^Furnace
^Motors ^Gas Pumps
^Garbage Disposal ^Dryer ^Water Heater
^A/C ^Electric Sign
^Other
DESCRIPTION OF ALL WORK BEING DONE ~IIY ~~~ P~~tf/1_ ~~'~
VALUE (Including labor and all materials includin light fixtures) $ ~~lJ . (~~._
MASTER ELECTRICIAN
3/02
~ ~5 c~