HomeMy WebLinkAbout0151866 - Building (interior remodeling) CITY OF OSHKOSH No 151866
OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1130 N WESTFIELD ST
Create Date 08/20/2012
Project Interior Remodel Project Number 20120156
Plan 08-3168-1010
Owner EVERGREEN MANOR INC
Contractor PACKER VALLEY BUILDERS, INC
Inspector Nicole Krahn
Designer
Type of Plan
Category 140-Interior Remodeling —
Zoning R-1 Square Footage
Const Class
Major Occ
Fire Protection O Sprinkled O Unsprinkled Sprinkler Design
Occupancy Permit Not Required Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Projection Canopies Signs
Use/Nature
of Work
'CO M/M 1 the bathroom t in counter (en the
the attached scope the living o w r
f room to open up the kitchen. Installing new kitchen cabinets and counter tops
and HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $9,800.00 Plan Approval $0.00 Permit Fee Paid $88.00 Park Dedication $0.00
1 Date 08/21/2012 Final/O.P. 00/00/0000
Issued Bym�J
Permit Voided I Parcel Id# 1608640000
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 •e stand e foe men••._• information.
Signature �. Z)/
_I
/ Date■rF ..� 4;0:4
Agent/Owner
Address 2277 CLAIRVILLE ROAD OSHKOSH WI 54904 - 0000 Telephone Number 920-232-7620
* 140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500-113 on the DNR
the Pre-Demolition nvironmental Checklist at http://dnr.wi gov/o g/aw/wm/publications/anewpub/WA651.pdfent in buildings see
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.
2012-08-17 17:37 Packer Valley/Nekimi 920 232 7622 > 9202365084 P 2/5
C Ciip of Oshkosh P x 1 130
Oshkosh,W15 5 499003-]130
Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application www.ci.oshkosh.wl,us
Project ` /�
. Address 1/.30 N kJe s 7 cP fJ ti /`l/i/io 3
Applicant Owner Contractor Tenant Other(describe)
—
Owner/ Name Ve l er1 Phone 973 3 --cP 2 4'D
Tenant (� n �� `—
Address /130 4/ i)es c�:G Email
Contractor Company Name PG 4y_- 4./dry. 14,Verr Ina Phone 02302 ` 74(a0
Contact OO4JC.
Email
Address ( c7 )77 C IQ ;r d,Pc, RJ '1Ze:S''i
State Credential#'s 1.$ 9 9 D 261_7
Dwelling Contractor Qualifier# Dwelling Contractor if Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project SQL. ,.9
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by ,QC e 2. Plumbing by Ra-c" •t -re'L Heating by
Value of Job Q �
$ 9 t DVS (Value for materials&labor is nq,to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check V Cash Permit Fee Account
/certify the above information is complete and accurate. Any deviations from the above submitted Irrformation may require additional permits
to be obtained. I acknowledge and agree to these terms. /
Name: y-- (PIeise print) Date: C.a Q45-/Az
Signature.!=:,
Received Time Aug. 17. 2012 5 : 54PM Ne. 0490