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No113628
CITY OF OSHKOSH
OSHKOSHBUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
THOMAS E/DENISE BLAZE
Job Address1656 RIVER MILL RDOwnerCreate Date04/21/2005
DesignerContractorPORTSIDE PROPERTIES INC
Category140 - Interior RemodelingPlan
TypeBuildingSignCanopyFenceRaze
ZoningClass of Const:Size
Sq. Ft.Projection
Unfinished/Basement0Rooms0Height0Ft.
Finished/Living
0Sq. Ft.Bedrooms0StoriesCanopies0
Garage0Sq. Ft.Baths0Signs0
Poured ConcreteFloating SlabPierOther
Foundation
Concrete BlockPostTreated Wood
Occupancy PermitRequiredFlood PlainHeight Permit
Park Dedication# Dwelling Units0# Structures0
SFR/ Remodeling the basement to include an office and tv area. A minimum ceiling height of 7' will be provided for 50% of the floor area.
Use/Nature
of Work
HVAC ContractorMCM AIR INCPlumbing ContractorPLUFF PLUMBING
Electric ContractorZIMMER ELECTRIC LLC
Fees: Valuation$23,050.00Plan Approval$0.00Permit Fee Paid$136.00Park Dedication$0.00
04/21/200500/00/0000
Issued By:DateFinal/O.P.
Permit Voided
Parcel Id #1224090000
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.
SignatureDate
Agent/Owner
923 S MAIN STOSHKOSHWI549020000426-1544
Address-Telephone Number
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 BUILDING PERMIT APPLICATION
Owner's Name Mailing Address Phone No.
6 \ 47-€ , Cam F v1 s e, I (i5(. RI,ve r- KU. V.4 r)._ I - (At-[b R
C tractor's Name: Mailing Address Lic /Cert # Phone No.
v 0y -- --\-5k.d.e_._ b l cS 9a3 S (ea; �A- (99 (s ( 9 cia -i5 `fq
Plumb Contra tor's Name: Mailing Address Lic /Cert # Phone No.
Electrical Contractor's Name: Mailing Address Lic /Cert # Phone No.
Z ■ rtN.11v\ - 2 r 900 C 5c0 Dm v o (/ � 1 � a 311 ( U) (p 2 5-D370
HVAC Contractor's Name: Mailing Address "�' Lic/Cert # Phone No.
V\ 0 cOa) al a (\/0 t-1 (gao) , - ilq 0)
--- -€.uroAd - R h; S k e,s vY. r PROJECT LOCATION
Building Address Subdivision Name Lot No.
l (.e 5 le 1? i.vv -ex M., I l I.
Zoning.District Setbacks: Front Rear Left Right
ft. ft. ft. -- ft.
PROJECT INFORMATION
OCCUPANCY AREA CONST. TYPE STORIES NUMBER OF
❑ Single Family Unfmished Basement sq.ft. ❑ Site Constructed ROOMS
0 Two Family ❑ Manufactured ❑ 1 -St _ Bathrooms
0 Other Living Area sq.ft. ❑ 2 -Story
FOUNDATION ❑ Bi -level _ Bedrooms
USE Garage sq.ft. ❑ Concrete ❑ Tri-level
0 Seasonal ❑ Masonry ❑ Quad -level — Remaining
HEIGHT Finished Rooms
0 Other
Other Height of the Structure (from fmal grade to the peak ❑ Other
of the roof)
FlAri Sh BS mci
ELECTRICAL PLUMBING WATER BUILDING COST
Panel Size: Sewer Sale Price of the Project $ f:; i f30 0
❑ 100 Amps ❑ Municipal 0 Municipal Utility (Final cost of house, lot & labor)
0 200 Amps ❑Septic ❑ Private On -Site Well MINUS
Service: Permit No.
0 Underground The Cost of the Lot $ . '–
❑Overhead MINUS - da
HEAT LOSS The Cost of the Mechanicals $ 15 0
Envelope Btu/Hr EQUALS =
The Cost of Construction $ 1 C j 0 et)
Infiltration Btu/Hr - (Fair market value which includes labor)
ENERGY SOURCE HVAC EQUIPMENT
0 Forced Air Furnace
Choices: Natural Gas, L.P., Oil, Elec, Solid, Solar 0 Radiant Baseboard or Panel
❑ Heat Pump
Space Htg 0 Boiler
0 Central Air Conditioning
Water Htg 0 Other
APPLICANTS SIGNATURE: – . DATE: L i 1 tU
Ohl Viv
C OI
3
i/dTF /
121-8' 14'-8 ' 118'
e
9 1
I :ET 1 . T OFFICE UN- FINISHED BASEMENT
1 6.-9 �1....... NO FLOORING
I I
1 1 STORAGE N
I I °R°RM°
1 ,1
I 2'43'
F
7 —
P..ER
T.V. ROOM $ illi C.1
`°
ING.EII 1 8T-3'
•
I O
m W.
r 1
I
T �
g FLOOR PLAN
BILLIARD t /
p,,,,, ROOM H g
17.8' i
. • T,. I— I .
M
II
ALTHOUGH TIP RAMS TO=EDBEHON.LLY.TIESE PLANS AND ELEVATIONS ARE NOT TO BE USED BY ANY CTlEL CONSTRUCTION CONTRACTOR WITHOUT HAVING THEU CHECKED AM REDRAWN FOR CONSTRUCT:N. IF PORTSIDE PROPERTIES RC. IS NOT TIE CONSTRUCTING CCOITRAC7DR THEN R IS MPOSSIBE
TO PROVIDE PERSONAL NO ON STTE CONSULTATION. SUPERVISION. AND CONTROL OVER ACTUAL CONSTRUCTION. THIS PORTON PROPERTES NC. E TO BE HELD INREIESS AND ASSUMES NO RESPV NSEERY TO ANY AND ALL POTENTIAL CLAMS MATING TO PLAN DESIGN ERRORS OR DEFECTS OF ANY TEL.
DOWER RUM. W. TORE.EIN..NO.MT.CH.IENOT TO EERCIW01109 ,.. COMO0 .8W1:0TOMGVT TWO PMIYNMVPoRI,at wMBIVTIwYriPBT GIST/w1(01. MITTEN PENNA. OF FORME PROWLS. NG
6
? E ° PROJECT: TOM &DENISE BLAZE DESIGNER/BUILDING CONSULTANT: JONA EIDEN -
> z Ea . PORTSIDE PROPERTIES, INC. g •- O.
E b y 923 SOUTH MAIN STREET OSHKOSH, WI 54902017 pt
N a " PLAN: 4261589 Q ? ���
EMA VOICE: IL Ieiden �POrtside prDPENU
4261544 FAX (920) es.�m � _ 111