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HomeMy WebLinkAbout0140006-Electric (smoke detector-Behavorial Health) (1)1 CITY OF OSHKOSH No 140006 OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 03/10/2010 Contractor EXCELLENCE ELECTRIC Category 643 - Commercial- Addition /Remodels Plan Service O New O Change O Temp • N/A Type O Overhead 0 Underground Volts Circuits Luminaires Amps Switches Receptacles Appliances Use /Nature of Behavioral Health Smoke Detector. Job #9662 Work Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $25.00 Issued By: Date 03/10/2010 ❑ Permit Voided Parcel Id # 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 1412 E MAIN ST LITTLE CHUTE WI 54140 - 2319 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 (Le. 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 Oshkosh, WI WI 54903-1130 ;hone (920) 236 -5050 Fax (920) 236 -5084 OJHKOJH 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 • 1 ou are a contractor , artici, 'tin! in the Permit Fee Account S stem and have ade, uate unds check here if you want this processed through vaur account ❑ DATE *4V/ JOB ADDRESS• © /5 1 ,6C>C)0 6 OWNER � L? /f �L=Z� / iii' Z- CONTRACTOR ' -EAJG' E. &L EC ./ C CHECK Bl ALL APPLICABLE "TSE CATEGORY JSingle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial Olndustrial SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable ❑Change ❑Not Applicable ❑Underground FILL IN THE APPROPRIATE BLANK WITH THE NUMBER Volts • / Receptacles # Circuits # Phase Amps Switches # Fixtures # • CHECK Ed ALL APPLICABLE ❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater ❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign ❑Motors ❑Gas Pumps ❑Other DESCRIPTION OF ALL WORK B G DONE ,6El 114/6 iR_ l 7 - RECEIVED "`ALUE (Including labor and all erials including light fixtures) $`500 °° MAR 8 2010 DEPARTMENT OF MASTER ELECTRICIAN ale T y COMMUNITY DEVELOPMENT ∎7-06 y�'�� INSPECTION SERVICES DIVISION 6�� _i "!' 3/02