HomeMy WebLinkAbout0099719-Electric (x-ray machine)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 99719
Create Date 02/06/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of COMM/New X-Ray machine in orthopedics.
Work
Fees: Valuation
Issued By:
$9,075.00
Plan Approval
$0.00 Permit Fee Paid
$180.00
Date 02/06/2003
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
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
9shkosh, WI 54903-1130
?hone (920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
OJ'HKO/H
ON THE WATER
· 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 conj. r-a~or participatin, g..in the Permit Fee Account System and have adequate funds, check here
(f you want ~s processed through ybur account []
~ .~C.r..~ ~ CX~. DATE //,~ 0/0 ~
OWNER "~ ~'
CONTRACTOR ~--~tc~LC~,~c~ ~c~-crA } c/
CHECK [] ALL APPLICABLE
f-USE CATEGORY
~Single Family I-1Duplex r'qMulti-Family
SERVICE DNew UITemporary
EIChange F1Not Applicable
F1Rental X~Commercial Fllndustrial
TYPE [:]Ov~/rh~d FINot Applicable
F1Ufderground
?
FILL IN TI-W. APPROPRIATE BLANK WITH THE NUMBER
Volts - / Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CI-W~CK [] ALL APPLICABLE
FIRange
F1Fan OR Blower
FIMotors
F1Dishwasher
F1Fumace
FIGas Pumps
F1Garbage Disposal FIDryer
F1A/C F1Electric Sign
F1Other
DESCRIPTION OF ALL WORK BEING DONE
ElWaterHeater
(Including labor and all materialS including light fixtures) $
MASTER ELECTRICIAN o~/~e.p.-( //~ V'A
3/02