HomeMy WebLinkAbout015165 - Building (remodel bathroom) 0 CITY OF OSHKOSH No 151652
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 9.26 N LARK ST Owner MARLENE M DREW
Create Date 08/13/2012
Designer
- _--___
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Contractor REBATH OF CENTRAL WISCONSIN
Inspector
Category * 140 Interior Remodeling
- - - --- - ----_- Plan
Type • Building O Sign — C Canopy 0 Fence ❑ Raze -- —
Zoning R-1 Class of Const:
Size
Unfinished/Basement Sq.Ft. Rooms
-- - — _—__ Height _ Ft. C Projection
Finished/Living Sq. Ft. Bedrooms
Stories Canopies
Garage Sq.Ft. Baths — —
— --- Signs
Foundation 0 Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post ❑ Treated Wood
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Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain
- -- ----- ---------—. Height Permit
ark De icati on #Dwelling Units p
- - -- #Structures 0
Use/Nature SFR/Remodeling the existing bathroom to include removing the existing tub and instaliing a new walk in tub with a wall surround. No
of Work other areas of the bathroom are being done.
i I
HVAC Contractor - --- ----
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Plumbing Contractor AHERN-GROSS INC.
Electric Contractor
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Fees: Valuation $10,500.00 Plan Approval $0.00 Permit Fee Paid
- — -- —_-_ $94.00 Park Dedication $0.00
Issued By: LA— — —
Date 08/13/2012 Final/O.P. 00/00/0000
❑ Permit Voided i Parcel Id# 1603150000
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
Date
Agent/Owner
Address 230 N KOELLER ST OSHKOSH WI 54902 4109 Telephone Number
---- --- - - P (920)303-5797
* 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.
Aug. 9. 2012 1 : 00PM REBATH CENTRAL WI 9203035935 • No. 2962 P. 17/18
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City 0 P 0 Box 1130
Oshkosh- Oshkosh,WI 54903-1130
Phone= 920 236-505
Building Permit Application Fax:(920) sii.wi. 4
www,ci.oshkosh.wi.us
Address Project
AlUl\______LOLt Sir s(A I 54%0_
Owner Contractor Tenant Other(describe)
Owner
Name J ` -6• r, `
- Phone
-
Address . 6 i ■ , a `
' ' Email
Contractor
Company Name
Phone_g_NI '!() 7H59:1___
9-�
Contact — ) '�
r?1 anal'LO r? QO m
Address # •
1J: ► it i r 1 • . t • _ • AfA II ,
State Credential #'s
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/
Designer _
Contact
Email
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Catagory •• . Alteration industrial
r ,
ZtihMann_Anewicke : l +_e i)aDc' - 1n
-F _• re A at i 0
Ql- v.,. ems- s ,A....ok e
, Mechanical Permits
Separate permits will be obtained for the following:
Electrical by, Plumbin g by... Y 11 Heating by
Value of Job s loaps.2:,p (Value for materials&labor is req. to ensure cansisrenc in accessing permit fees for all applicants.)
Payment by: • Check # Cash
Permit Fee Account
I certi.fj,the above information is complete and accurate, Any deviations from the above submitted infrormarion may require additional permits
to be obtained I acknowledge and agree to these terms.
Name: - • a ,. UA1/ez
(Please print) Date: QfrOj2 j'-
Signature: i •1, •`����
Received Time Aug, 9. 2012-12: 50PM—No. 038341
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