HomeMy WebLinkAbout0127010-Building
G
OSHKOSH
ON THE WATER
Job Address 4012 HEMLOCK CT
CITY9F OSHKOSH
BUILDING PERMIT - APPLICATION AND RECORD
No
127010
Owner PORTSIDE BUILDERS
- ~~ --.
Create Date
09/25/2007
Designer
Contractor 1:>()F3I~_I_[)~E3LJl~Q~B~2lf'.J_~:~_____ ,
Category
L1Q-=-.f\J.~w Si.nJlJ~U:;~'!!iIy~__.,
Plan 044-0907
Type
.!3_~i.l~~___,_.o_~_i[f!___~____Q.~~.noeL_
Q_~ence
Raze
Zoning
R-1 PD
Class of Const: 8
Size Ir!~____
Unfinished/Basement
1431 Sq.Ft.
__..!~! Sq. Ft.
~~ Sq. Ft.
Rooms
6
Height
20 Ft.
O_~ojection I
Finished/Living
Bedrooms
Canopies
Garage
Baths
2
2
Stories
Signs
Foundation . Poured Concrete 0 Floating Slab
o Concrete Block 0 Post
o Pier 0 Other
o Treated Wood
Occupancy Permit Required
Occupancy Fee
$0.00 Flood Plain No
Height Permit Not ReqlJi~ec:i..,
# Structures
Park Dedication
F3~quire.<:l___
# Dwelling Units
Use/Nature iN~n=R/ New single family* 1 story, 2 car attachea'ga'rage and 12' x 13' :5"creck. The driveway will be concrete.
of Work I
---1
I
I
I
.,___.__ .,__,. ..1
HV AC Contractor
MCM AIR INC
Plumbing Contractor SBS PLUMBING LLC
Electric Contractor P&J KAMPO ELECTRIC INC
Fees: valuatio~JJ_~556.09
Issued By: ~
Plan Approval $75.00 Permit Fee Paid
$619.00 Park Dedication $200.00
~~-----------_._--- ~---,_._-_._--_.
Date 09/28/2007
Final/O.P. 00/00/0000
-~---_.__.
o Permit Voi~
Parcelld #
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,~essa~ :pprov~for.~ start. in.. 9 such activity. aI. j'{1J i~.. 7
Signature \._-(l~ .i}...~ -\..-9-/ J'<..~ Q Date _ JLO Lv ~
Agent/Owner
Address
980 AMERICAN DR
NEENAH
WI 54956 - 1363
Telephone Number
920-727-4874
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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.
o
OSHKOSH
ON THE WATER
GRADE STAKE FORM
Name PORTSIDE BUILDERS
Address
Lot UNIT #5 lot 14
Block
Subdivision Hemlock Ct
Zone
4012 HEMLOCK CT
Street Number
Lot Dimensions
Building Grade Elevation Stakes Set At Site 09/25/2007 Set By NO GRADE REQ'D
Grade Stake Number 7464
Create Date 09/25/2007
Ward
Wl~ewalk Exi~~J
Department of Public Works
I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation
has commenced. ,-,\f). -_ ,-p~)
"--'1 t .A.<iJ....Le...- '\ a
e
OSHKOSH
ON THE WATER
Job Address 4012 HEMLOCK CT
PARKLAND DEDICATION FEE COLLECTION RECORD
Address
Name PORTSIDE BUILDERS
NEENAH
Subdivision Hemlock Ct
980 AMERICAN DR
Lot UNIT #5 lot 14
Building Permit Number 0127010
Number of Dwelling Units
Fee Required
Owner's Signature
Inspector's Signature
1
-.-----
Number of Structures
$200.00
Fee Paid
0r)1,l~l/'\~d!
Date 09/28/2007
WI
54956
1
--~-~_.__.-
Date
CIW07
Date
Wisconsin Department of Industry,
Labor and Human Relations
Safety and Buildings Division
P.O. Box 2509
Madison, WI 53701-2509
Wisconsin Statues 101.63, 101.73
WISCONSIN UNIFORM
BUILDING PERMIT
APPLlCA TION
Application No.
0127010
Parcel No.
o Constr 0 HVAC 0 Elec 0 Plbg
Mailing Address
980 AMERICAN DR
Plbg Lic/Cert # Mailing Address
6461 980 AMERICAN DR
Plbg Lic/Cert # Mailing Address
647786 50 PHEASANT CT
Plbg Lic/Cert # Mailing Addr.ess
4264 6122 COUNTY ROAD M
Plbg Lic/Cert # Mailing Address
246943 4635 RED FOX RD
o Erosion
o Other:
Telephone No.
NEENAH
WI 54956 - 0000
Telephone No.
NEENAH WI 54956 - 1363 920-727-4874
Telephone No.
APPLETON WI 54915 - 4527 (920) 730-8556
Telephone No.
WINNECONNE WI 54986 _ 9780 920-582-4402
Telephone No.
OSHKOSH WI 54904 - 7784 920-410-5933
S . ft.
Subdivision Name
Hem lock Ct
1/4,
1/4,Section ,T
Lot No.
UNIT #5 lot 14
Left
N,R E(or)W
Block No.
Living Area
Garage
1431
.. - _.._--~-_.._._----
1431
--.-_._--
528
o Masonry
Treated Wood
Other
o Seasonal
o Permanent
o Plus Basem~ 0 Other 0 Private On-Site Well
The applicant agrees to comply with all applicable codes, statues and ordinances and with the conditions of this permit, understands that the issuance of
the permit creates no legal liability, express or i~F d, ~n th~_ Dep- rtment . r m icipality; and certifies that all the above information isrc~urate.
APPLICANT'S SIGNATURE \~--1' I 'Q...-' DATE SIGNED er LdgLOl
APPROVAL CONDITIONS This permit is Issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalty
SEE "STANDARD CONDITIONS OF APPROVAL" SHEET
o Village 0 City 0 County 0 State of:
City Of Oshkosh
Municipality Number of Dwelling Location:
7 0 2 6
Inspection
Wis. Permit Seal
Other
Total
SBD-5823 (R. 07/92)
$30.00
-/ Construction
o HVAC
o Electrical
o Plumbing
o Erosion
o
Name JOHN ZARATE
Date 9/28/2007
$105.00
352322
Cert. No. 70330
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