HomeMy WebLinkAbout0154680 - Electric (power and data for new accelerator) el) CITY OF OSHKOSH No 154680
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 02/20/2013
Contractor VAN ERT ELECTRIC CO INC Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause
Service 10 New O Change O Temp • N/A Type O Overhead 0 Underground
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances Linear Accelerator
Use/Nature of COMM/ POWER AND DATA FOR NEW LINEAR ACCELERATOR,ALSO PROVIDE RACEWAYS FOR VENDOR CABLING,
Work LIGHTING AND RECEPTACLES EXISTING ARE TO REMAIN **check#4060
Fees: Valuation $30,000.00 Plan Approval $0.00 Permit Fee Paid $318.00
Issued By: W Date 03/08/2013
Ei 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 2000 PROGRESS WAY KAUKUANA WI 54130 -9562 Telephone Number (920)766-3888
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
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 O fO f H
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
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 ❑
DATE —7—/3
JOB ADDRESS MCR.GY CA Aic&R CtSAI Rag RECEIVED
OWNER A F F f.0{ r ti � EA/...-rH S
CONTRACTOR VIA/ FZ'v &- c—rR I L COM PAN MAR 0 8 2013
DE'" TMEO'
CHECK®ALL APPLICABLE comma-'; •' DEVELOPMENT
INSPECT;O 5ERv7CES DI 'tSJON
USE CATEGORY
CI Single Family ❑Duplex ❑Multi-Family ❑Rental iCommercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead SNot Applicable
❑Change Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK 1 ALL APPLICABLE
ORange ❑Dishwasher OGarbage Disposal . ❑Dryer DWater Heater
OFan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps FLOther 2,,v6,a Ac.C f A ore
DESCRIPTION OF ALL WORK BEING DONE 1 G L.�L R ¶ DATA [71'Q Ale ,L)A/CA k
/ACC e.le:-ov+0:-, ALSO P,2av,pE rQAc�wA r 1/6'AiA.1 re CA R..ANC- , 1Gf1Ti-✓c
/aN REGCPTACt...5 A c Ex'sr,ju 1-0 /PC^)A/Al
VALUE(Including labor andall.materials including lighfix $ sSOf 600
/MASTER ELECTRICL .,AN;,:: r /4 =
pL2mr7' /8"'
716 '43'C-A 3/02