HomeMy WebLinkAbout0155430-Building � CITY OF OSHKOSH No 155430
�
OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
JobAddress 500 S OAKWOOD RD Create Date 05/01/2013
Project Remodel _ Project Number 20130440
Owner MERCY MEDICAL CENTER OSH INC Plan Z4-3740-0513
Contractor BOLDT OSCAR CONSTRUCTION
Inspector Nicole Krahn
Designer
Category 220-Alteration Hospitals&Institutions Type of Plan Alt.Level 2
Zoning C-1 PD Square Footage
Major Occ Business Const Class
Fire Protection '� Sprinkled � Unsprinkled � Sprinkler Design
Occupancy Permit Not Required Flood Plain No Height Permit Not Required
Park Dedication Not Required #Dwelling Units 0 #Structures 0
� Projection � Canopies Signs
Use/Nature
of Work
COMM/Remodel existing rooms(IH565 office, IH570 case management, IH555 vestiblule and IH560 o�ce)to create a coffee shop and food prep
area.(Boldt Job#62704) **check#126739
HVAC Contractor TWEET GAROT MECHANICAL INC Plumbing Contractor TWEET-GAROT MECHANICAL INC
Electric Contractor PIEPER ELECTRIC INC
Fees: Valuation 78,500.00 Plan Approval $0.00 Permit Fee Paid $261.00 Park Dedication $0.00
Issued By: ��� Date 05/04l2013 Final/O.P. 00/00/0000
❑ Permit Voided !� Parcel Id#0613660000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
I have read and understand the afore mentioned information.
Signature Date
AgenUOwner
Address PO BOX 419 APPLETON WI 54912 - 0000 Telephone Number 739-6321
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
P O Box 1130
� City af Os��osh Oshkosh,WI 54903-1130
� Phone:{920)236-5050 �
Fax:(920)236-5084
Building Permit Application """•��°S�k°Sb.�;.us
Project s� s. (�b�. �. �� `
Address �e�v !o��.
Applicant Owner ontrector Tenant Other(describe)
Owner/ Name • � /�t�,,c..� (r✓�avD Phone .�a?O� a'ZoZ3- LY��<"
Tenant
Address,�ap s ��,,,�� �� Email a,
Contractor Company Name � � t�� ��,...,�.w� Phone 90� -vZ.'Z'S��f `�
Contact ��,J������,Q,(' Email � �,
Address c�5'�'�.U_ r2o���' �� A-�Ql�, t,..7� �lo�
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State Credenrial#'s , ,
Dwelling Contractor Qw�ifier# Awe(ling Contractor# Building Contiactor Registration#
Achitect/ Company Name }�r/� Phone 4I`�- 2.75 � 33�9�$'
Designer
Contact �d�(�. �,,a..�� Email w�.���1.qa.. e..�..�
Address �333 �_.r��- ��� �-r�. �;�c.�.a�� t�1 �aoo�
Permit Type Residential Single Famity Residential Duplex Commercia Multifamily Industrial
Catagory New Additiaa terati �
Project � -�. nlb Co�
Descriprion
���c•�t- . t f�-SS"� I�u�.:�J�e •� t�'S��o t`�t.�
i`ti� v�.�� Co�e� �.�►0 a..�.�. -��. D�D o.��.
Mechanical Separate pernuts will be obtained for the following:
Permits Electrical by �� t.(' Plumbing by)w� �� Heating by�i.�c�� �/!�r[
Value of Job $ 7$��.Q'� alue for materials&labor is r to ensure consistenc in accessin
j N eq. y g permit fees for all applicants J
Payment by: Check # Cash Permit Fee Account '
I cert�tlie above tnformatto»is complete and accurate. Any detidations from rhe above subu�ined b fonnation rnay reguire addiNonal per►nfts
to be obtar� o��ledge mrd agree to these terms. �
Name: ��1� � �:��� (Pleaseprint) Date:_ � o"�//�
Signature: