HomeMy WebLinkAbout0143265-Building (?D CITY OF OSHKOSH No 143265
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2405 LAKESIDE CT Owner AMIR/CONNIE V ROSENBAUM Create Date 09/22/2010
Designer Contractor TEMPO HOMES INC
Category * 140 - Interior Remodeling Plan
Type • Building O Sign 0 Canopy O Fence O Raze
Zoning Class of Const: Size
Unfinished /Basement Sq. Ft. Rooms Height Ft. ❑ Projection
Finished/Living Sq. Ft. Bedrooms Stories Canopies
Garage Sq. Ft. Baths Signs
Foundation • Poured Concrete 0 Floating Slab O Pier 0 Other
0 Concrete Block 0 Post O Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication # Dwelling Units 0 # Structures 0
Use /Nature SFR/ Basement Remodel *Remodeling the basement to include a bedroom, family room and bathroom.
of Work
HVAC Contractor MCM AIR INC Plumbing Contractor WATTERS PLUMBING
Electric Contractor CUMINGS ELECTRIC INC
Fees: Valuation $22,900.00 Plan Approval $50.00 Permit Fee Paid $157.00 Park Dedication $0.00
Issued By:-.
Date 09/22/2010 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id # 0614401700
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 enfor easement restrictions of which it is not a party, if you perform the work
described in this p= it - •plication within an ease- ent, the City strongly urges the permit applicant to contact the easement
holder(s) and to s =cure a y necessary : •. ova b •r- tarting such activity.
I have read and u •ersta d the afore r - ntio• -d ' fo ation. 9 •
Signature s A t
Date
Agent/Owner
Address 601 • - uN ST STE D7 OSHKOSH WI 54902 - 5979 Telephone Number 231 -4920
* 140 - Interior R lilting See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500 -113 on the DNR
Asbestos Program website; http : / /dnr.wi.gov /air /compenf /asbestos /. For additional information on hazards present in buildings see
the Pre - Demolition Environmental Checklist at http: / /dnr.wi.gov /org /aw /wm /publications /anewpub /WA651.pdf
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
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 01HK01H
Building Permit Application ON THE WATER
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account (l
JOB ADDRESS 2 /o c / D� a,
OWNER ) C j,i /6 leQ SW3 , 11
CONTRACTOR -- 7744/ 9 70 r t /,V c
I am the: ❑ Owner OR contractor
_US CATEGORY
Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
Work being done:
❑ Addition ❑ Deck/Porch/Patio ❑ Driveway/Parking
❑ External Remodeling ❑ Fence/Hedge/Kennel ❑ Garage/Utility Structure
❑ Handicap Ramp ❑ Hot Tub /Spa 'Internal Remodeling
❑ Sign/Canopy /Awning ❑ Stair/Handrail ❑ Stove/Fireplace
❑ Swimming Pool ❑ Wrecking Permit
❑ Other
Additional information, such as plan submittal and approval, may be required before issuance. Fliers,
located in the hallway, may be referenced to note if any additional information is necessary.
❖ Full description of work being done: j r/yl( F / /S ff /rtf- M f L'' —
Any work not included in this application is not permitted.
Value of the job $ c "1 , goo (Value for materials and labor is required to ensure consistency in accessing permit fees for all
applicants.)
PLEASE READ, SIGN, & DATE:
I certify the above information is complete and accurate. Any de tions from the above submitted
information may require additional permits to be obtained I a. o ledge and agree to these terms.
Name: ,v i Cam, 0
Lip (Please pr's
Signat e:
Date: /
3/02
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