HomeMy WebLinkAbout0145503-Building (misc. alterations) CITY OF OSHKOSH No 145503
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 222 JACKSON ST Owner GREGORY R/JUDY NELSON Create Date 04/12/2011
Designer ddK Engineering Contractor T J CONSTRUCTION INC
Category 232 - Alteration Stores & Customer Service Plan No Formal Rev
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 O Other
0 Concrete Block O Post 0 Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain No Height Permit Not Required
Park Dedication Not Required # Dwelling Units 0 # Structures 0
Use /Nature Frame ceiling below existing roof, install vapor retarder, insulation, liner panels. Fur out walls, install vapor barrier, osb. Install steel
of Work panels over existing roof with Ridge Vent to vent attic, all as per plans provided.
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $20,000.00 Plan Approval $0.00 Permit Fee Paid $148.00 Park Dedication $0.00
Issued By: Date 04/18/2011 Final /O.P. 00 /00 /0000
❑ Permit Voided Parcel Id # 0101540000
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 184 MEADOW LN COLUMBUS WI 53925 - 0000 Telephone Number (920) 210 -5920
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
0
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 0/1 (KED f —
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 n
JOB ADDRESS 2) a J <.. c l- 5 C k1 j - I - 05 k l< o s k WI-
OWNER L% f ec1 We'San
CONTRACTOR 7-) Cell 5 t k.,<..4 i 61/ � C q °o a/6 - 9a6
I am the: ❑ Owner OR SeContractor
USE CATEGORY ' •
❑Single Family ❑Duplex ❑Multi - Family (Mental igif ommercial ❑Industrial
Work being done:
❑ Addition ❑ Deck/Porch/Patio ❑ Driveway/Parking
❑ External Remodeling ❑ Fence/Hedge/Kennel ❑ Garage/Utility Structure
❑ Handicap Ramp ❑ Hot Tub /Spa Xlinerrial Remodeling
❑ Sign/Canopy /Awning ❑ Stair/Handrail ❑ Stove/Fireplace
❑ Swim4 Pool ❑ Wrecking Permit
er ' $-fee i 1 A
For External Remodeling, Wrecking Permit, and Internal Remodeling please 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: //d nr.wi.aov /ora /aw/wm /publications /anewpub/WA651. pdf.
Additional information, such as plan submittal and approval, may be required before issuance. Fliers,
located in the hallway, may be referenced to note if an additional information is necessary.
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61 H/ 14 ' 4 -s 12II Uei4 -00 Anv work not included in this application is not permitted.
Value of the job $ .90i 06C.) (Value for materials and labor is required to ensure consistency in accessing permit fees for all
applicants.)
PLEASE READ, SIGN, & DATE:
1 certify the above information is complete and accurate. Any deviations from the above submitted
information may require additional permits to be obtained. .1 acknowledge and agree to these terms.
P6-44c r R q r "iJ o f L h Name: i s t� e l-
(Please print)
C Okhlh14.s wz 5 ? e....'.-------->. Na Signature: �sR, �50
Date: V- /S- 1/
3/02