HomeMy WebLinkAbout0103280-ElectricOSHKOSH
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 843- Commercial-Addition/Remodels
Type I~ Overhead
Circuits 0
Switches 0
No 103280
Create Date 08/04/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of COMM/ Wiring for 4th floor storage area. *Job #3418-X31.
Work
Fees: Valuation
Issued By:
$5,300.00 Plan Approval
$0.00 Permit Fee Paid $120.00
Date 08/04/2003
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.
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
~shkosh, WI 54903-1130
.. bone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
THE W~TER
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 participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account []
JOB ADDRESS ---~
OWNER
CONTRACTOR CSv-O -Z& 3
DATE
CHECK [] ALL APPLICABLE
viSE CATEGORY
. 'ISingle Family r-IDuplex
F1Multi-Family
SERVICE F1New
[]Change
[3Tempomry
~l.Not Applicable
[2Rental EICommereial
TYPE []Overhead ~Not Applicable
[]Underground
FILL IN THE APPROPRIATE BLANK WITIt TIlE NUMBER
Volts · / Receptacles # Circuits #
Phase
Amps Switghes # Fixtures #
CIIECK [] ALL APPLICABLE
[]Range ElDishwasher ElGarbage Disposal [3Dryer
FIFan OR Blower [3Furnace EIA/C F1Electric Sign
EIMotors [2Gas Pumps [2Other
DESCRIPTION OF ALL,WORK BEING DONE ~--~ .~-Lc~,,Z_ ~-/~-- ~,o_~
[3Water Heater
? 'ALUE (Including labor and all materials including light fi~ures) $'~t ~C'4~ ~
MASTER ELECTRICIAN ~Y-/7~9~./ /~-~/.~
3/02