HomeMy WebLinkAbout0156998-Electric (2 receptacles) � CITY OF OSHKOSH No 156998
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1128 E PARKWAY AVE Owner HEALTH CARE REIT INC Create Date 07/31/2013
Contractor FAITH TECHNOLOGIES, INC. Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause
Service � New � Change � Temp � N/A � Type � Overhead 0 Underground i
Volts 120 Circuits Luminaires
Amps 20 Switches Receptacles 2
Appliances
i
I
Use/Nature of OMM/instal�(2)receptacles on 20A circuit �
Work
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Fees: Valuation $200.00 Plan Approval $0.00 Permit Fee Paid $30.00
Issued By: '��i Date 07/31/2013
d
� Permit Voided�� 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
AgenUOwner
Address PO BOX 260 MENASHA _WI 54952 -260 Telephone Number (920)738-1513
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.
City of Oshkosh �
Division of Inspection Services �
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084
QN N WA
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 Wl 54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
�ti�u nre a contractor�articipalin�in the Permit Fee Account Svstem and have adequate funds check here
�vou want ihis nrocessed through vour accoun[ ❑
DATE �[
JOB ADDRESS �� /�-� � v a-�-� r`'��
OWNER -�.��-�- �ECEIVED
CONTRACTOR ` � ' JUL 312013
CHECK�ALL APPLICABLE DEPART'1Fr�T OF
COJ1�iUViTi'�F�riOP�IEYT
USE CATEGORY �� IYSPECTICtV SEf:\�res�;;���siov
OSingle Family ❑Duplex ❑Multi-Family �Rental QCommercial ❑Industria�
SERVICE ❑New �Temporary TYPE ❑Overhead �t Applicable :
❑Change �t Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts �� / Receptacles# r _ Circuits#
Phase
Amps �� Switches# Fixtures#
CHECK�ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps �Other
DESCRIPTION OF ALL WORK BEING DONE
l��Q� ��� r�.� ,�-4�� uw�_�c � 1� ✓P-�2�- � o�-�-yo �+i rc�,��.$" ,
VALUE(Including labor and all materials including light fiactures)$ ��D �
l�X�— �^
MASTER ELECTRICIAN � '
3/02