HomeMy WebLinkAbout0157356-Electric � CITY OF OSHKOSH No 157356
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 07/15/2013
Contractor PIEPER ELECTRIC INC Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause
Service New 0 Change � Temp � N/A � Type � Overhead � Underground I
Volts Circuits Luminaires
Amps _ Switches _ Receptacles
Appliances
I
Use/Nature of COMM/Mercy Medical/Remodeling the 2nd floor OB suite. This will be a three phase remodel with a new reception and waiting area,
Work new added exam rooms,added procedure room and updated ultrasound rooms. A new conference room will be added and a nurses ,
�vork area.(Job#13079-7C) "check#s 28649&28689
"PENDING ADDITIONAL$123.75"'
�
' - _ I
Fees: Valuation $79,785.00 Plan Approval _ $0.00 Permit Fee Paid $493.00
Issued By: Date 08/21/2013
❑ Permit Voided I 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
AgenUOwner
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 �
Oshkosh,WI 54903-1130
Phone(920)236-5050 , ��
Fa� (920)236-5084 � � K H
Ot'-1?:VATFQ
ELECTRICAL PERMIT APPLICATION
Att mformation after baid categories must be provided�.
Incomplete applications will not be processed.
• Application(s)and fee(s)cau be brouglzt to City Hall,Room 205 or mailed to Inspection Services,PO Bax 1128,
Oshkosh WI 54903-1128. Commencing work without peimit(s)will result in fees being doubled or$100.00 plus the
norn�al permit fee,which ever is greater.
OR
Ifxou are a contractos participating in the Permit Fee Account Svstem and have adeguate,furcds. check here
if vou want this pr•ocessed through vour accoun_t ❑
DATE ��3
JOB ADDRESS����� �Q��� �'
- 1 /� �2ECEIVED
OwNER ' ' +��G�.I ��1�C�.\ ( Q r����"
� �~,c, - AUG 19 2013
CONTRACTOR�t-e�2� � 1e�'°F'
CHECK�ALL APPLICABLE DEPARTI1£Y"f OF
CO\7�1UViTY DEVELOP�fEVT
INSPECTIO��FR�'ICES Ul�'IS10V
USE CATEGORY
❑Single Family ❑Duplex �Multi-Family ❑Rental �Commercial ❑Industrial
SERVICE �New ❑Temporary TYPE ❑Overhead �Iot Applicable
❑Change �Not Applicable CJUnderground
FILL IN THE APPROPKIATE BLANK WITH THE NUMBER
Volts �Z� / ��$ Receptacles# Circuits#
Phase� �
Amps Switches# Fiztures#
CHECK Q ALL APPLICABLE
ORange ODishwasher ❑Garbage Disposal �Dryer ❑Water Heater
�Fan OR Blower OFurnace �A/C �Electric Sign
�Motors �Gas Pumps ❑Other
DE�TION O ALL WO BEING DO
Kern � o� O� �
00
VALUE(Including labor and all mate ' including light fiatures)$ �
�
MASTER ELECTRICIAN �
��� � ��� � �� �� - 3�oz
�
3o7q- ��