HomeMy WebLinkAbout0145089-Building CITY OF OSHKOSH No 145089
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 03/08/2011
Designer Rober H Grapentin Contractor CG SCHMIDT
Category 220 - Alteration Hospitals & Institutions Plan
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze
Zoning Class of Const: Size
Unfinished /Basement Sq. Ft. Rooms Height Ft. ❑ Projection
Finished/Living Sq. Ft. Bedrooms Stories Canopies
Garage Sq. Ft. Baths Signs
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupancy Permit Required Occupancy Fee $0.00 Flood Plain No Height Permit Not Required
Park Dedication Not Required # Dwelling Units 0 # Structures 0
Use /Nature Hospital / Construct rated walls to enlarge storage space on 4th floor as per plans.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $12,820.00 Plan Approval $0.00 Permit Fee Paid $106.00 Park Dedication $0.00
Issued By: Date 03/08/2011 Final /O.P. 00 /00 /0000
❑ 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 n- - ssary approvals before starting such activity.
I have read and understa • afore me coned info ion. Q /
Signature U MW Date 3 .�J '/ 1
Agent/Owner
Address 117 LAKE PARK DR MILWAUKEE WI 53224 - 3021 Telephone Number 414 - 577 -1177
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.
City of Oshkosh
Inspection Services Division
PO Box 1
Oshkosh, WI 54903 -1130 /
Phone: (920) 236 -5050
Fax: (920) 236 -5084 OJHKOJH
Building Permit Application ON THE WATER
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account fl
JOB ADDRESS x S • Qa � Q�
OWNER 1v\ (Cvt VV e.cltJ CaL4I■
CONTRACTOR 1 lrw c �
I am the: ❑ Owner OR )ontractor
USE CATEGORY / / / ///
❑Single Family ❑Duplex ❑Multi - Family ❑Rental ]Commercial ❑Industrial
Work being done:
❑ Addition ❑ Deck/Porch/Patio ❑ Driveway/Parking
❑ External Remodeling ❑ Fence/Hedge/Kennel ❑ Garage/Utility Structure
❑ Handicap Ramp ❑ Hot Tub /Spanternal Remodeling
❑ Sign/Canopy /Awning ❑ Stair/Handrail ❑ Stove/Fireplace
❑ Swimming Pool ❑ Wrecking Permit
❑ Other
Additional information, such as plan submittal and approval, may be required before issuance. Fliers,
located in the hallway, may be referenced to note if any additional information is necessary.
❖ Full description of work being done: I r, L c A
Any work not included in this application is not permitted.
Value of the job $ 2— `2) tO (Value for materials and labor is required to ensure consistency in accessing permit fees for all
applicants.)
PLEASE READ, SIGN, & DATE:
I certify the above information is complete and accurate. Any deviations from the above submitted
information may require additional permits to be obtained. I acknowledge and agree to these terms.
Name:
(Please print)
Signature:
Date:
3/02
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