HomeMy WebLinkAbout0159858-Electric �
� CITY OF OSHKOSH No 159858 ,
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 03/14/2014
Contractor PIEPER ELECTRIC INC Category 643-Commercial-Addition/Remodels Plan
Inspector Adam Krause
Service New � Change � Temp � N/A � Type � Overhead 0 Underground I
Volts Circuits Luminaires
Amps Switches Receptacles
Appliances �— - -
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Use/Nature of OMM/MERCY MEDICAU Interior remodeling for the pediatric clinic relocation.(Job#14048-7C) "check#344391 `
Work
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Fees: Valuation $96,289.00 Plan Approval $0.00 Permit Fee Paid $550.01
Issued By: �t,� Date 03/21/2014
� 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
AgenUOwner
Address 5070 N 35TH ST _ MILWAUKEE WI 53209 -5302 Telephone Number 920-886-6800
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.
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CIL}�Of�S�:COS�1
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-I130
Phone(920)236-5050 uV u
Fax (920)236-5084 f� ( �
Cti'�=VYniF.: -
EIECTRICAL PERMiT APPLiCATtON
All information after boid categories mnst be provided.
Incomplete applications will not be processed.
� Application(s)and fee(s)can be brought to Ciry Hall,Room 205 or mailed to Inspection Senrices,PO Box 1128,
Oshkosh WI 54903-1128. Commencing worlc without permit(s)will result in fees being doubled or$100.00 pius the
normal permit fee,which ever is greater.
I ou are a corttOraRctor artici atinP in the Permit Fee Account Svstern and have adeauate �d�. check here �
�vou want [his Drocessed through vour account ❑
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CONTRACTOR . �� r� � � M A R 21 2 014
CHECK 0 ALL APPLICASLE ��'- '� ``'��'' `'�
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USE CATEGORY
❑Single Family ODuplex L]Multi-�amily ❑Rental �Commercial �Industrial
SERVICE ONew OTemporaty TYPE OOverhead J�Not Applicable
OChange �Not Applicable L7Undergraund
FILL IN THE APPROPRIATE BL.ANK WITH THE NUMEER
Volts / Receptacles# Circuits# �
Phase
Amps Switches# Fixtures#
CHECK�ALL APPLICABLE
4
❑Range ❑Dishwasher ❑Gaz'bage Disposal �Dryer C1Water Heater
❑Fan OR Blower �Furnace DA/C OElectric Siga
❑Motors ❑Gas Pumps �Other�QC�•cxl��
DESCRIPTION OF ALI.WORK BEING DONE ��� � � � t�.� �r ��
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VAL,UE(Including labor and all materials including light fish►res)$ �`e � ��yC�
MASTER ELECTRICIAN � �
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