HomeMy WebLinkAbout0099849-Electric (elevators)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 99849
Create Date 02/17/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of COMM/Additional elevators.
Work
Fees: Valuation
Issued By:
$10,000.00
Plan Approval
$0.00 Permit Fee Paid
$180.00
Date 02/17/2003
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
/'~ ')shkosh, WI 54903-1130
2hone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
ON THE WATER
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
I_f_¥ou are a contractor participatin, g in the Permit Fee Account System and have adequate funds, check here
(f you want this processed through ¥~ur account []
ATE
cHECK [] ALL APPLICABLE
~'~USE CATEGORY
,'lsingle Family F1Duplex F1Multi-Family FIRental
SERVICE rlNew F1Temporary TYPE
r'lChange FINot Applicable
FILL IN TIlE APPROPRIATE BLANK WITH THE .NUMBER
Volts - / Receptacles #
Phase
Amps Switches #
r-IIndustrial
[:]Overhead
[:]Underground
%
Fixtures #
CHECK [] ALL APPLICABLE
[:]Range [:]Dishwasher [:]Garbage Disposal I-IDryer
I-IFan OR Blower [3Furnace [3A/C F1Electric Sign
[3Motors [3Gas Pumps [3Other ..
[:]Water Heater
DESCRIPTION OF ALL WORK BEING DONE A D~ i T/o,~'/~ ~
/AL[TE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN / A g ~ ¥ /~A ~/A &g,~re/
3/02