HomeMy WebLinkAbout0144722-Building (weatherization) CITY OF OSHKOSH No 144722
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 333 W SOUTH PARK AVE Owner DEREK C DAHLKE Create Date 01/24/2011
Designer Contractor ADVOCAP INC
Category * 140 - Interior Remodeling Plan
Type • Building 0 Sign 0 Canopy 0 Fence 0 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 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication # Dwelling Units 0 # Structures 0
Use /Nature SFR/ Air sealing, attic and wall insulation, installation of exhaust ventilation and installation of poly over the crawlspace floor per the
of Work attached proposal.
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $3,910.69 Plan Approval $0.00 Permit Fee Paid $46.00 Park Dedication $0.00
Issued By: Date 01/24/2011 Final /O.P. 00 /00 /0000
❑ Permit Voided Parcel Id # 0904180000
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.
I have read and understand the afore mentioned information.
Signature Date
Agent/Owner
Address PO BOX 1108 FOND DU LAC WI 54936 - 0000 Telephone Number (920) 426 -0150
* 140 - Interior 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.
Cit) of Oshkosh
Inspection Services Division
P0Box1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 /� Of' —<O`f
Buildin Permit Application ON THE WATER
I ou are a contractor •artici•atin: in the Permit Fee Account S stem and have ade•uate unds check here
if you want this processed through your account t
DAHLKE, HEATHER 89294
JOB ADDRESS 333 W. SOUTH PARK AVE. 0
OSHKOSH, WI 54902 410 -1942 420 -4533
OWNER
CONTRACTOR AD vO C,9P �n ,
I am the: ❑ Owner OR • Contractor
USE CATEGORY
X 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 l4JEA77/&2 /j477a,,/
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: F A7711litbD
RECEJVE
JAN 21 2011
Any work not included in this application is not ermp fitted. _ UNITY DEVELOPMENT
Value of the job $ (Value for materials and labor is required to ensure con ECT N GESoDIVISION
applicants.)
PLEASE READ, SIGN, & DATE: •
I cert 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: Jre,v.e._ / 11 a
(Please print) ,
Signa e 1���---- ----�-
Date: /— ZO— //
3/02
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