HomeMy WebLinkAbout0124766-Electric (MRI equipment)
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OSHKOSH
ON THE WATER
Job Addreliis 500 S OAKWOOD RD
Contractor EXCELLENCE ELECTRIC
CITY OF OSHKOSH
No
124766
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner MERCY MEDICAL CENTER OSH INC
Create Date 05/14/2007
Service
p New
Category 643 - Commercial-Addition/Remodels
o Change 0 Temp
. N/A
Type 0 Overhead
Plan
o Underground
Volts
Circuits
Luminaires
Appliances
Switches
Receptacles
Use/Nature of Mercy Medical/Replace MRI equipment. Job #8717.
Work
Fees: Valuation
$2,850.00
U~
Plan Approval
$0.00
Permit Fee Paid
Issued By:
$94.00
Date 05/14/2007
o Permit Voided I
Parcelld # 0613660000
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.
Signature Date
Agent/Owner
Address
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.
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City of Oshkosh
Division of Inspection Services
/,-~.O. Box 1130
~lshkosh, WI 54903-1130
I "-:"hone (920) 236-5050
Fax (920) 236-5084
~
OfHKO/H
ON THE WATf:R
ELEQTRICAL PERMIT APPLICATION
All infonnation after bold categories must be provided.
Incomplete applications wili 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. Commen~ing 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 participatinf! in the Permit Fee Account System and have adequate funds. check here
if vou want this vrocessed throuf!h vb.ur account 0 '
DATE SaD7
JOBADDRESS .500 S. OA;tOC, 0eRG~ f}o~PJr".) R~ EIV
OWNER ,A f-YJAhTY CA1-7H
CONTRACTOR C~Ccl.f...cNCC CLGc.Ykl c.jr./llCh
,
D
MAY 1 4 2007
CHECK fa ALL APPLICABLE
( ~'JSE CATEGORY
. ,.,' ..JSingle Family
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
DDuplex
DMulti-Family
DRental
TYPE
~mmercial o Industrial
o Overhead ONot Applicable
OUnderground
SERVICE ONew
OChange
OTemporary
ONot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts .
Phase
Amps
I
Receptacles #
Circuits #
$witc.hes #
Fixtures #
CHECK fa ALL APPliCABLE
ORange
OFan OR Blower
DMotors
ODishwasher
OFumace
DGas Pumps
OGarbage Disposal
OAlC
'DOther JIl ~ L
o Dryer OWater Heater
OE1ectric Sign
DESCRIPTION OF ALL WORK BEING DONE
New ./"'\f\J: G&.\JIPMc/l/T eRe-pI-Ac.t; ex \S'TJ.NG- J
r", ,
/ , !ALUE (Including labor and all materials including light fixtures) $ Ol. 8S0
MASTER ELECTRICIAN r-yb,v !-I A SIc .s
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3/02