HomeMy WebLinkAbout0151657 - Building (remodel the bathroom) CITY OF OSHKOSH No 151657
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1.930 SIM_PSON ST Owner STEFANIE K GREEN
Create Date 08/13/2012
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector Nicole Krahn -Category * 140 Interior Remodeling
Plan
Type • Building Q Sign Q Canopy 0 Fence Q Raze
Zoning R-1 Class of Const:
--.----- Size
Unfinished/Basement Sq. Ft. Rooms
Height Ft. L] 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 Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/Remodeling the existing bathroom.
of Work � - --- -- --- - .
HVAC Contractor Plumbing Contractor MT. MORRIS PLUMBING
Electric Contractor —Fees: Valuation $2,500.00 Plan Approval $0.00 Permit Fee Paid $39.00 Park Dedication
- - - - $0.00
Issued By: —
Date 08/13/2012 Final/O.P. 00/00/0000
Permit Voided j Parcel Id# 1409700000
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 (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 : 0OPM • REBATH CENTRAL WI 9203035935 No. 2962 P. 15/18
. . .4., ` City �+/�/ Pn Box 11.30
•
I y f OsOosA • Oshkosh, W154903-1130• Phone:(920)236-5050
Fix:(920)236-5084
Building'.Permit Application www.ci.oshkosh.wi.ps
Project
Address I• O . , i. i .. J gii . .Osih t', 5
t 1 •(�(.) i �' o a
Applicant Owner Contractor -Tenant • Other(describe)
Owner/
Name c1-r Pa 11 e
Green�r�� _ Phone
Address i• .4 at.,*� u r r * Email
Contractor Company Name
Phone _ ,
Contact Z — ) OR I Email 2e
G[V
Address et ''!
—sA N: ` i r. 1 I. , a • • dif . ._..1 ira
State Credential#'s
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor R.cgistration#
Achitect/ Company Name
Designer Phone
Contact Email •
•
• Address
•
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration•
Project
Description .
._Ba3t1 ,0M:_eelyinfita : . • . I II
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. • Mechanical Separate•permits will be obtained for the following:
. , Permits Electrical b
y- Plumbing by MI- Nit orr i S. . Heating by
'Value of Job $ Z-400.bp_
(Value for materials&tabor is req_to ensure co'
onsistent in accessing permii fees for all applicants.)
Payment by: • ' Check # Cash' Permit Fee Account •
I cerr6)the above information is comp/etc and accurate. 4ny deviations from the above submitted information may require additional permits
to he obtained. I acknowledge and agree to these terms.
Name: . .1_.`.. h i
(Please (�U,
print) Date: 0 -a c2)---/2._
Signature: , • 1I •
. 6 .
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Received Time Aug. 9. 2012 12: 50PM No, 0383