HomeMy WebLinkAbout2011-Building (windows) 11113) CITY OF OSHKOSH No 145948
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1416 RUSH AVE Owner ANDREW J /DAYANA R BREHMER Create Date 05/18/2011
Designer Contractor DIMENSIONAL DESIGN LLC
Inspector John Zarate
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. ❑ 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 / Install 8 window replacements in existing openings.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $4,200.00 Plan Approval $0.00 Permit Fee Paid $53.00 Park Dedication $0.00
Issued By: Date 05/18/2011 Final /O.P. 00 /00 /0000
❑ Permit Voided Parcel Id # 1609470000
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 —7' 2 -7 Date 5 l f
Agent/Owner
Address W5230 PLEASANT RD BLACKCREEK WI 54106 - 0000 Telephone Number
* 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
PO Box 1130 r4
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 Of HKOf H
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 rj
JOB ADDRESS / 1 j 6 R05 11 S7'
OWNER DA Nl4 Ro2 04 l�F�
CONTRACTOR DI tv�s i N OkSIGrJ LL-C-
I am the: ❑ Owner OR pr Contractor
USE CATEGORY
IASingle 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 IA IN 00 L S
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: r ... c3u R' pocas k kat9cE 0714
7 Any work not included in this application is not permitted.
/�
Value of the job $ "f zoo (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 I acknowledge and agree to these terms.
Name: /4477 O6I1t AQ�
(Please print)
Signature: 7
Date: S
3/02