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Home My WebLink About0146377-Building CITY OF OSHKOSH No 146377 OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1043 W SOUTH PARK AVE Owner CITY OF OSHKOSH Create Date 06/15/2011 Designer Contractor OWNER Inspector Category * 161 - Wrecking Residential Dwellings Plan Type 0 Building 0 Sign 0 Canopy 0 Fence • 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 Duplex/ Raze structure" All utilities shall be properly abandoned. of Work HVAC Contractor Plumbing Contractor Electric Contractor Fees: Valuation $7,500.00 Plan Approval $0.00 Permit Fee Paid $0.00 Park Dedication $0.00 Issued By: 13fi,v Date 06/15/2011 Final /O.P. 00 /00 /0000 ❑ Permit Voided Parcel Id # 1307340800 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. *Raze 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 aforementioned information. Signature Date Agent/Owner Address PO BOX 1130 OSHKOSH WI 54903 - 1130 Telephone Number 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 °1 4 Inspection Services Division P Box 1130 Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 O1HKOlH Fax: (920) 236 -5084 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 Ft JOB ADDRESS (043 (0445 5o L Pc, - k A 1i- OWNER cr L 2) os kegs , CONTRACTOR C' (3 a$ 054 tort, I am the: / pi Owner OR ❑ Contractor USE CATEGORY DSingle Family ❑Duplex DMulti-Family DRental DCommercial ❑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 AP Other 1)e a 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: C19 c o ,1( ,p(c j (S 4 4- ,a f h Any work not included in this application is not permitted. Value of the job $ 7/ 9 Q (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: S uev R. 60 G�.�IC (Please print) Signature: Y Date: 6(0 3/02 REQUEST FOR EXCEPTION TO REQUIRED SEWER AND WATER ABANDONMENT REGULATIONS Date 6 /Sill Address of building /O 3 9 /0 4 J l U 9 3 JvgS tJ So 1, Petek Name of Owner C j -Ey o- cDsLk o S')\ Address of owner The undersigned Master Plumber requests that the requirement for abandonment of the sewer and water laterals for this address not be required to meet the ordinance for abandonment at the property line before raze or removal of the served structure. (Check one or provide Information) • The utilities will be reused for new construction at this site within twelve months of the date of request for exception. If the utilities will not be reused within this time frame they will be properly abandoned at the property line per ordinance requirements no later than twelve months from date of this request. • The utilities will be properly abandoned after the structure is removed to make the utilities accessible for abandonment. The utilities will be secured against damage during demolition and until they can be abandoned to meet the requirements of ordinance. (Not to exceed 60 days) PA\ • Other reasons for the requested exception: y 4) pn p &r�\ a 11 n don a 1 k k.kl (Continue on the reverse side of form if necessary) Master Plumber Date Master Certificate Number Mailing address Approved: / Date (/�J' /J J (Plumbing In • ctor)