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CITY OF OSHKOSH
114064
No
OSHKOSHELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job AddressOwnerCreate Date05/04/2005
2700 W 9TH AVEMERCY MEDICAL CENTER OSH INC
ContractorEXCELLENCE ELECTRIC, INC.Category643 - Commercial-Addition/RemodelsPlan
ServiceTypeOverheadUnderground
NewChangeTempN/A
VoltsCircuits0Fixtures0
Amps0Switches0Receptacles0
Appliances
Use/Nature of MOB/Wiring for remodel of Suite 107 as per plans approved by HFS. Job # 8239
Work
Plan Approval$0.00
Fees: Valuation$7,900.00Permit Fee Paid$162.00
Issued By:Date05/16/2005
Permit Voided
Parcel Id #0613670000
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.
SignatureDate
Agent/Owner
PO BOX 78LITTLE CHUTEWI5414078920-687-2442
Address-Telephone Number
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.