HomeMy WebLinkAbout0152719 - Building (Suite 225 remodel office space) CITY OF OSHKOSH No 152719
OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Create Date 09/26/2012
Project INTERIOR REMODEL Project Number 20120217
Owner MERCY MEDICAL CENTER OSH INC Plan Y4-3644-0912
Contractor CG SCHMIDT
Inspector Nicole Krahn
Designer
Category 220-Alteration Hospitals&Institutions Type of Plan Alt. Level 2
Zoning C-1PD Square Footage 3166 SQ FT
Major Occ Const Class
Fire Protection 0 Sprinkled 0 Unsprinkled I Sprinkler Design
Occupancy Permit Not Required Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
D Projection Canopies Signs
Use/Nature
of Work
COMM/SUITE 225/DR GU/Remodel of existing office space into exam rooms.
HVAC Contractor BASSETT MECHANICAL Plumbing Contractor BASSETT MECHANICAL
Electric Contractor PIEPER ELECTRIC INC
Fees: Valuation $60,0 Plan Approval $0.00 Permit Fee Paid $268.00 Park Dedication $0.00
Issued By: [1. � Date 10/03/2012 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 io secure any necessary approvals before starting such activity.
I have read and.,undecstand the afore mentioned information.
Signature i•t,—l\.A Date/0.3/
Agent/Owner
Address 11777 W 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.
of i IA City of Oshkosh
Illir
P 0 Box 1130
0
Oshkosh, WI 54903-1130
Phone:(920)236-5050
Fax: (920)236-5084
www.ci.oshkosh.wi.us
Building Permit Application
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Applicant Owner €613uar-tot` ' Tenant Other(describe)*
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State Credential 4's
Dwelling Contractor Qualifier# Dwelling Contractor it Building Contractor Registration 4
Achitect/ I It-' U ("
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Designer
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Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project P 1.1-T -Cefij---, rt
Description --. .CN CttSC (1.. C) (. .)(...(A,rr■ (C)`-t.\-....)
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Mechanical Separate permits will be obtained for the following:
Permits ,-),
Electrical by r ( Plumbing by rA:).51:,N trii:i,414.1'\'(‘--H eating by , <1,6, 2
Value ofJob $ o, 00 0 (Value or materials& labor is rey to ensure consistency in accessing permit tees fix all applicants.)
Payment by: Check ii- Cash Permit Fee Account
I certify the above information is complete and accurate. Any deviations/corn the above submitted information may require additional permits
to be obtained. I acknowledge and agree to these terms.
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Name: ,....A.\--A_Lc 0._ CAN( \`--)1..._ r,:, c i'-, (Please print) Date: c.,/la 4_
1/4____ ;,;) .
Signature: ,,..:-.i, r.---Z--- _l ,:f. „....,--- (...7-.
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