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Home My WebLink About0146189-Building (&) CITY OF OSHKOSH No 146189 OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 910 W NEW YORK AVE Owner MATTHEW R/KANDACE D WILSON Create Date 06/03/2011 Designer Contractor OWNER Inspector John Zarate Category * 140 - Interior Remodeling Plan Type • Building 0 Sign ❑ 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 ❑ Concrete Block 0 Post ❑ Treated Wood Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit Park Dedication # Dwelling Units 0 # Structures 0 Use /Nature SFR\ Remodeling former upper unit space to create a bigger bathroom and a walk -in closet of Work HVAC Contractor Plumbing Contractor HOMEOWNER Electric Contractor HOMEOWNER Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid $39.00 Park Dedication $0.00 Issued By: /9 ,[ te D a t e 06/03 /2011 Final /O.P. 00 /00 /0000 ❑ Permit Voided Parcel Id # 1204090000 Cautionary Statement to Owners Obtaining Building Permits 101.65(1 r) of the Wisconsin Statutes requires municipalities that enforce the Uniform Dwelling Code to provide an owner who applies for a building permit with a statement advising the owner that: If the owner hires a contractor to perform work under the building permit and the contractor is not bonded or insured as required under s. 101.654 (2) (a), the following consequences might occur: (a) The Owner may be held liable for any bodily injury to or death of others or for any damage to the property of others that arises out of the work performed under the building permit or that is caused by any negligence by the contractor that occurs in connection with the work performed under the building permit. (b) The Owner may not be able to collect from the contractor damages for any loss sustained by the owner because of a violation by the contractor of the one and two family dwelling code or an ordinance enacted under sub. (1) (a), because of any bodily injury to or death of others or damage to the property of others that arise out of the work performed under the building permit or because of any bodily injury to or death of others of damage to the property of others that is caused by any negligence by the contractor that occurs in connection with the work performed under the building permit. * 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 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 aforemectioned information. Signature (fib a°` A, ZJ Date Agent/Owner Address 910 W NEW YORK AVE OSHKOSH WI 54901 - 3642 Telephone Number Matt work # 751-561i 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 OJHKOIH 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 f JOB ADDRESS q 1 t "EA" Yo21C AVE OWNER Malin -t- K A N N Wl1AN CONTRACTOR I am the: Igt Owner OR ❑ Contractor USE 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: ZtJD FcooR k nfQ_ooM 414 VTILI e t2 ,/1 (PI vi-ouS Kt FRo i DLO t.e.K (1� io L b w +ru AOOinoNAZ Sfrikrzoom. SPArcE 4140 ' Ci �t-r ,. Yr f. AS1 . 'kD1ZoOM. 0.4e11A - CI 6 / C S'1WC CfaSf�T s- 4f/J BR'f1Mo�wt &wpm aM r Fvw MAO- - v ' t4. plot' kfJ' IWt57fR- t1 kAQool1 Amp &urn &Mit • Any work not included in this application is not permitted. Value of the job $ ? (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: MATT E4t/ w ( lam nJ ((,, (Please print) Signature: ; Date: 3 y 3/02