HomeMy WebLinkAbout0102233-ElectricOSHKOSH
ON THE WATER
.lob Address 1130 N WESTFIELD ST
Contractor ARROW ELECTRIC OF OSHKOSH
Service [~ New (~ Change
Volts 120/208
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner EVERGREEN MANOR INC
Category 643- Commercial-Addition/Remodels
Amps 1600
~ Temp
Type I~ Overhead
Circuits 0
Switches 0
No 102233
Create Date 06/16/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances Range, Fan or Blower, Motors, Dishwasher, Furnace, Garbage Disposal, A/C, Dryer and Water Heater.
Use/Nature of Nursing Home / New addition to existing building.
Work
Fees: Valuation
Issued By:
$400,000.00 Plan Approval $0.00 Permit Fee Paid
$1,350.00
Date 06/17/2003
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 P O BOX 3960 - 280 E FERNAU AVE OSHKOSH WI 54903 - 3960 Telephone Number
(920) 426-4252
Cfty of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5054
f ECE VED
JUN 1 6 200J
ELECTRICAL P E I~ [~,~Jp~,lc IC,.AT I 0 N
All information af~i~e~'~u~tlb[J~rovided.
Incomplete applic atio~s* ~v~l ~n(~[ [t[~r.o~-~ T
O 'HKO/H
ON T~E \,VATER
· 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
.If you are a contractor participating in the Permit Fee Account SYstem and have adequate funds, check her(:
if you want this processed through your account []
DATE
CHECK [] ALL APPLICABLE
uSE CATEGORY ...............
[] Single Family •Duplex []Multi-Family
SERVICE ~New UITemporarY
I-IChange UINot Applicable
IZlRental J~gCommercial
[]Industrial
TYPE U1Overhead
J~0'Underground
F-INot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts ~) / ,c~ Receptacles # Circuits #
Phase ~_~
Amps /~Oi) Switches # Fixtures #
CHECK [] ALL APPLICABLE
J~Range
g]Fan OR Blower
~Motors
ID[Dishwasher
,l~Furnace
[]Gas Pumps
[gl'Garbage Disposal
~rA/C
FIOther
I~]'Dryer
F1Electric Sign
A~Water Heater
DESCRI,PTION OF ALL WORK BEING DONE
VALUE (Including lab°r and all materia? ineludi~Txtures)$
3/02
Electric Permit Work Card
Job Address 1130 N WESTFIELD ST Permit Number 1'02233 Create Date 06/1612003
Owner EVERGREEN MANOR INC Contractor ARROW ELECTRIC OF OSHKOSH
Category 643 - Commercial-Addition/Remodels
Service ~) New O Change(~ Temp ~) N/A ] Type
Volts 120___/20__8~ ............. Circuits 0 Fixtures 0
Am ps 1600 Switches 0 Receptacles 0
Fee $1,350.00 [] Value $400,000.00
Appliances :~ange, Fan or Blower, Motors, Dishwasher, Furnace, Garbage Disposal, NC, Dryer and Water
-leater.
Use/Nature Nursing Home / New addition to existing building.
of Work
Inspections:
Date 06/19/2003
Type Temporary
E.C. did not have a permit
Faxed to WPS 6/19/03, Mailed 6/23/03
Inspector Kevin Benner ~_ approved
Date/Time requested: 06/17/2003 09:33 AM Notice Type:
Access:
Phone Number:
Ready Date/Time: 06/13/2003 07:58 AM Requested by:
O Reinspect Fee (~ Fee Wavied [] Reinspect Fee Paid