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HomeMy WebLinkAbout0153815 - Electric 0 CITY OF OSHKOSH No 153815 OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 11/26/2012 Contractor PIEPER ELECTRIC INC Category 643-Commercial-Addition/Remodels Plan Inspector Adam Krause Service FO New 0 Change 0 Temp • N/A Type 0 Overhead 0 Underground Volts 120/208 Circuits Luminaires Amps Switches - Receptacles Appliances it Use/Nature of COMM/MERCY MEDICAL/Rennovations to suite 106,cardiology. Two existing nurse stations will be removed and two new exam Work rooms will be created. The cardio record area will also be modified to a new work station. **check#27518&27540 Fees: Valuation $4,100.00 Plan Approval $0.00 Permit Fee Paid $128.00_ Issued By: (/' "VV Date 12/04/2012 ❑ 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.Oshkosh,Oshkosh,WI 54903-1130 Phone(920)236-5050 Fax (920)236-5084 a1-Cf---- 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$100.00 plus the normal permit fee,which ever is greater. OR If you are a contractor oarticipatinz in the Permit Fee Account System and have adequate funds. check here if you want this processed through your account ❑ DATE /// 24// JOB ADDRESS, p© S Oute.00oJ- OWNER Mere. LCc._ 0„gr l-e,c NOV 2 8 2012 CONTRACTOR v,c.._ CHECK Q ALL APPLICABLE USE CATEGORY ❑Single Family ODuplex ❑Multi-Family ❑Rental Xommercial ❑Industrial SERVICE ONew ❑Temporary TYPE ❑Overheadot Applicable DChange ;1AIot Applicable ❑Underground FILL IN THE APPROPRIATE BLANK WITH TIIE NUMBER Volts /a 0 I .O 8 Receptacles# Circuits# Phase Amps Switches# Fixtures# CHECK Q ALL APPLICABLE ❑Range ❑Dishwasher DGarbage Disposal ❑Dryer ❑Water Heater ❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign ❑Motors DGas Pumps ❑Other DESK' 'TION OF ALL WORK BEING DONE ex a rv. S' m®r,-, 5 4/1 / O VALUE(Including labor and all materials including light res)$ '/� � MASTER ELECTRICIAN / 60-el 3/02