HomeMy WebLinkAbout0103121-Electric (donor wall)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
500 S OAKWOOD RD
EXCELLENCE ELECTRIC, INC.
I~ New (~ Change (~ Tamp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner MERCY MEDICAL CENTER OSH INC
Category 643- Commercial-Addition/Remodels
Type I~ Overhead
Circuits 0
Switches 0
No 103121
Create Date 12/31/2002
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of COMM/ Lighting for donor wall in Mercy Hospital entrance corridor. *Job# 3653.
Work
Fees: Valuation
Issued By:
$4,450.00 Plan Approval $0.00 Permit Fee Paid $105.00
Date 07/25/2003
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 321 E MAIN ST PO BOX 78 LITTLE CHUTE WI 54140 - 78 Telephone Number
(920) 687-2442
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.
Division of Inspection SerVices
Oshkosh, WI 5490~-11~
ELECTRICAL
Ail inform~
PERMIT
JOE m~DRESS ._~OO ~ oW~Z>
CONTRACTOR ~-d~ ~--~7~/~_~
must be
not be processed.
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY DUPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE NEW CH~/~GE TEMPORARY ~______APPL I CAB_L~A~
~'~ NO. OF FIXTURES sWITCHES RECEPTACLES CIRCUITS
VOLTS / PHASE
CHECK ALL APPLICABLE
P. ANGE WATER HEATER GARBAGE DISPOSAL DRYER
DISHWASHER FD/~ OR BLOWER FURNACE A/C.
ELECTRIC SIGN MOTORS GAS PUMPS OTHER
DESCRIPTION OF
· Submit payment with application. Failure to pay within 30 d~ys will resulk in
fees being doubled or $~0~00 plus t~e normal permit fee, whlch ever is
greater.
('-~VALUE (Tncluding labor =a ,II ~,=i.l~ i~=l~i=g light fixtu=ss) $