HomeMy WebLinkAbout0143504-Building (excavate 3 walls) CITY OF OSHKOSH No 143504
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1103 W NEW YORK AVE Owner FRIEDA P HOPPE Create Date 10/07/2010
Designer Contractor SURE - DRY - BASEMENT SYSTEMS INC
Category * 141 - Exterior Remodeling Plan
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze
Zoning Class of Const: Size
Unfinished /Basement Sq. Ft. Rooms Height Ft. 0 Projection
Finished /Living Sq. Ft. Bedrooms Stories Canopies
Garage Sq. Ft. Baths Signs
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication # Dwelling Units 0 # Structures 0
Use /Nature SFR / Excavate and stabilize 3 walls, draintile and sump pit. Licensed Plumber will install sump pump.
of Work
1
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $17,861.00 Plan Approval $0.00 Permit Fee Paid $136.00 Park Dedication $0.00
Issued By: Date 10/07/2010 Final /O.P. 00 /00 /0000
❑ Permit Voided Parcel Id # 0502660000
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 se e any necessary approvals before starting such activity.
I have read an. end- to *afo - ;f�! / ` -
Signature �"'
Date 42 -/D
Agent/Owner
Address 754 W AIRPORT RD MENASHA WI 54952 - 1409 Telephone Number 920 - 967 -9655
* 141 - Exterior Remodeling 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 O
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 fl
JOB ADDRESS 1 / r) 3 L( Th v'- /c 4..,,
OWNER "F ` nl" 4. bWC'
CONTRACTOR . — PC 7
I am the: ❑ Owner OR )ontractor
USE CATEGORY
/ingle 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
reAther - Fr>v ., A.1 4-t 72, pa I
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.
t
• Full description of work being done: Eke, ,4, - 2, S ? .,'/.' Z a.4 1
fi4 to t.✓/I iii. Pte.. r, "F ,'1 e 3 5 41,
Anv work not included in this application is not permitted.
Value of the job $ / 7 '6 / (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 deviations from the above submitted
information may require additional permits to be obtained. I acknowledge and agree to these terms.
Name: A - P Cla a*
Signature: ��_.
vs, Date: w /] /lo
3/02
y �� For Olflce Use Only
IN�9TALLATION I� r i , � � ®
Sure Basement Systems Ins.
1 -800- 379 -3788
754 Weat Alrpoit Road, Menasha, W( 54952
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Type of Well
fodt O Stone AN material is guaranteed to be as specilied. M work to be completed according to Industry standard practices. Any alterotlon from above
O P OIWSI I Colrorets specifications will be executed only upon wrtlten orders, and will become an extra charge. Agreements are contingent upon accidents as delays.
O o1w beyond our control. Sure-Dry of Wisconsin (SDW) workers are fully covered by Workman's Compelsatlon Insurance. Though we will do our
beet to avoid such, homeowner assumes all responsibility for damages due to breakage of hidden fuel or service loses. AI proposals based
7jpe of Wall Finish: primarily on homeowner's description ms. Customer shell grant SDW a 60 day right to remedy any problem after reported. Homeowner
IekY over - is responsible • preparing for job Installation (See belle of this agreement for details). SDW will hold 10% of the total contract price if cancelled
4EJPi nellng O etude after 3 day it ....: I. This.proposal may be withdrawn by SDW I not accepted within 60 days. Payment to be made in ful upon
138h eetrock O funrrg 1 1 >�J •
• O Other / d
J10 of Floor Finish: -
`O Qwi ciela OTIle �� -. Aeq red S
g psoos,t °
O Other C pose to famish materiel and labor In accordance with above spedficallons for: Pard a '_� •; �i! �'
Iry
a m hale J /. t C' YWi i s l� J t Cat dollars 9l p�
• ` InDatenadorh.:�l
Acceptance of Proposal - The above prices, speciftcatons, conditions ■Dry t3aeernem Seisms c omer h a s ce r $ci X
a copy y ollhe
he
and separate warranty are satlsfactory and are hereby accepted. 'bu are authodmd
to do the wodc as specified. Payment wS be made as outlhed above. A full perimeter system was recomnlgnded X
• ATripleSafe Pumping System was recommended X_
signature Ns j •; Q' /, Q Customer is avrare of warranty X�
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