HomeMy WebLinkAbout0151468 - Building (replace windows, doors) (a) CITY OF OSHKOSH No 151468
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3109 BELLFIELD DR Owner STEVEN J/MARY E PENTONY Create Date 08/02/2012
Designer Contractor PRAIRIE CRAFTSMAN CONSTRUCTION INC
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type • Building O Sign O Canopy 0 Fence 0 Raze
Zoning R-1 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 O Floating Slab 0 Pier O Other
0 Concrete Block 0 Post O Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR\Replacing windows and doors,replace flooring and kitchen cabinets. If any electrical or plumbing work is done,separate permits
of Work will be needed
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: .e•- Date 08/02/2012 Final/O.P. 00/00/0000
`< ��. ❑ Permit Voided Parcel Id# 1381030000
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 app ' af starting such activity.
I have read and unde • - fo - 7),01. mation.
� iSignature Date d�
� /
Agent/Owner
Address 3160 OMRO RD OSHKOSH WI 54904 - 0000 Telephone Number 920-231-6991
* 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
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.
G G P O Box 1130
City of Os!Gkos! . Oshkosh, WI 54903-1130
Phone: (920)236-5050
Fax: (920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address : i ' 3ELL. t LV,
Applicant ❑ Owner N-"Contractor ❑ Tenant ❑ Other(describe)
Owner/ Name S1-C V 6 �Errcb 1'J 1 Phone
Tenant
Address �1d9� g t i.- "�-b Email
Contractor Company Name L_A`5'T " sir U.-C- Phone `- 33z6
Contactjt-ID", LAS% Email
Address 14g3 L t p &i PT lep
State Credential#'js2f// , , 12.2.2:7g5
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type fiCResidential Single Family ❑ Residential Duplex ❑ Commercial ❑ Multifamily ❑ Industrial
Catagory ❑ New ❑ Addition X Alteration
Project ?PLPC-1 WIN �a 11.20{2- NCSrevcr. CRANGE"
Description
i Pl.AcE. fø f LOese.1N4
eLPLAct exTCA.E0 CAZ I N t N C175
Mechanical Separate permits will be obtained for the following:
Permits ❑ Electrical by 113r) ❑ Plumbing by TEV ❑ Heating by
Value of Job
$ 2a1ec (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: ❑ Check #/Z 6;;L- ❑ Cash ❑ Permit Fee Account
I certib,the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be obtained. ,II acknowledge and agree to these terms.
Name: awy A 8' _ _ (Please print) Date: er.01�2O/2.--
Signature: /j�, ,0. / � ///