HomeMy WebLinkAbout0152656 - Electric (interior alterations) CITY OF OSHKOSH No 152656
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 0.9/24/2012
Contractor PIEPER ELECTRIC INC Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause
Service 0 New 0 Change O Temp • N/A Type O Overhead O Underground
Volts 120/208 Circuits - 5 Luminaires 1
Amps Switches 4 Receptacles 15
Appliances
Use/Nature of FLOOR 2(DR GU'S SUITE)/INTERIOR ALTERATIONS (JOB#291517) **check#27280&27284
Work
Fees: Valuation $5,809.00 Plan Approval $0.00 Permit Fee Paid $1.45.00_
Issued By: C J if + I VlJ Date 09/28/2012
❑ 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 5070 N 35TH ST MILWAUKEE WI 53209 -5302 Telephone Number (414)462-7700
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
Division of Inspection Services
P.O. Box 1130
1101
Oshkosh, WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084
0-
VATF
fl I 5 • 1/IP 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$100.00 plus the
normal permit fee, which ever is greater.
OR
.ou are a contractor sartici atin! in the Permit Fe Account S stem and have ade uate unds check here
vou want this processed through VOUF account
DATE if 2 /2-
JOB ADDRESS (.50 5. Op itc.-7430.d .
OWNER re- Mm , . n -ex- RECEIVED
CONTRACTOR
SEP 2 7 2012
DEPARTMENT
CHECK RI ALL APPLICABLE
COMMUNITY DEVELOPMENT
USE CATEGORY INSPECTION SERVICES DIVISION
OSingle Family ODuplex DMulti-Family DRental , Commercial Clindustrial
SERVICE ONew OTemporary TYPE ElOverhead ElNot Applicable
ClChange t;ir'Jot Applicable OUndergrottnd
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / ,20 Receptacles 4 /6 Circuits# 5--
Phase
Amps
Switches Fixtures #
CHECK RI ALL APPLICABLE
ORange ODishwasher OGarbage Disposal 0Dryer OWater Heater
OFan OR Blower OFurnace DA/C DElectric Sign
DMotors OGas Pumps 00ther
DESCAAPTION OF ALL WORK BEING DONE
".■ t
f,.(,r•oc14. s )12 5 _7)(_)%-tC,
S o0 "
VALUE(Including labor and all materials including light fixtures)$ 5go2 "
MASTER ELECTRICIAN
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