HomeMy WebLinkAbout0146599-Building (city re-hab) 1:& CITY OF OSHKOSH No 146599
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 421 DOVE ST Owner UDOM PUTHORNSRI /MAI LEE THAO Create Date 05/06/2011
Designer Contractor DRIESSEN CARPENTRY
Inspector Nicole Krahn
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 0 Poured Concrete 0 Floating Slab 0 Pier 0 Other
• 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 / Replace front storm door, garage gutters, guardrail for basement steps, vent kitchen range hood, and 1 new vinyl stationary
of Work replacement window (same size & location).
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $32.00 Park Dedication $0.00
Issued By: jyyl Date 06/29/2011 Final /O.P. 00 /00 /0000
❑ Permit Voided Parcel Id # 1610280000
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 un tand the fore mentioned information.
Signature / Date
Agent/Owner
Address 0 COUNTY ROAD K OSHKOSH WI 54904 - 0000 Telephone Number (920) 231 -7145
* 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
P O Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 O
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 1- 7C9 I 10d 1/C,
OWNER ie L at co • . r u I 0 ' A— C c
CONTRACTOR i Carrie/
I am the: ❑ Owner OR ,Contractor
USE CATEGORY
❑Single Family ❑Duplex ❑Multi - Family ❑Rental 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
❑ 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: O I 4 7 / Petiah
Any work not included in this application is not permitted.
Value of the job $ c:2660 (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: Z iv ce A✓
(Please print)
Signature '��,-----
Date: ( n l 4
3/02