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Home My WebLink About0151880 - Building (gutting upstairs bdrm) . ( ...$) CITY OF OSHKOSH No 151880 OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 651 W 11TH AVE Owner DEVEN D ADAMS/SAMANTHA L WILD Create Date 08/22/2012 Designer Contractor OWNER Inspector Nicole Krahn Category * 140-Interior Remodeling Plan Type • Building 0 Sign O Canopy O Fence 0 Raze Zoning R-2 Class of Const: Size Height Ft. ❑ Projection Unfinished/Basement Sq.Ft. Rooms Hei 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 0 Treated Wood Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit Park Dedication #Dwelling Units 0 #Structures 0 Use/Nature SFR/Gutting upstairs bedroom down to the studs. Insulating and finishing with drywall. Headers and fire blocking will be added if of Work missing. All construction shall comply with State and local building codes. HVAC Contractor Plumbing Contractor Electric Contractor Fees: Valuation $1, Plan Approval $0.00 Permit Fee Paid $32.00 Park Dedication $0.00 Issued By: �.� -•, - Date 08/22/2012 Final/O.P. 00/00/0000 ❑ Permit Voided I Parcel Id# 1303740000 Cautionary Statement to Owners Obtaining Building Permits 101.65(1 r)of the Wisconsin Statutes requires municipalities that enforce the Uniform Dwelling Code to provide an owner who applies for a building permit with a statement advising the owner that: If the owner hires a contractor to perform work under the building permit and the contractor is not bonded or insured as required under s. 101.654(2)(a),the following consequences might occur: (a)The Owner may be held liable for any bodily injury to or death of others or for any damage to the property of others that arises out of the work performed under the building permit or that is caused by any negligence by the contractor that occurs in connection with the work performed under the building permit. (b)The Owner may not be able to collect from the contractor damages for any loss sustained by the owner because of a violation by the contractor of the one and two family dwelling code or an ordinance enacted under sub.(1)(a),because of any bodily injury to or death of others or damage to the property of others that arise out of the work performed under the building permit or because of any bodily injury to or death of others of damage to the property of others that is caused by any negligence by the contractor that occurs in connection with the work performed under the building permit. *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 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 secur any necessary approvals before starting such activity. (� —, // —1 I have read and and stand the aforementioned inf ion. Date Q��y( oC Signature /'%�dZL%U�/`ld'2G-Z , /e�1C�'��1'LL-t Agent/Owner Address 651 W 11TH AVE OSHKOSH WI 54902 - 6309 Telephone Number 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 P O Box 1130 City of Oshkosh Oshkosh,WI 54903-1130 Phone:(920)236-5050 Fax: (920)236-5084 Building Permit Application www.cioshkosh.wi.us Project k iv ii�� Address ( 5 t , I roil !e_, Csvx. lush vu_r- 5`t io a_ Applicant Own Contractor Tenant Other(describe) Owner/ Name V e.V\ o O-fl\ Phone(gab) (y`l - oS- 17 �c Tenant Address CS.-1 110, 14-t-tiL 4,..A.&)C._ tSi LoSh / c,J1' Email C tractor 5,4`Z o 3` Company Name Phone ontact Email Address State Credential , , bwglling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration# A hitect/ Company Name Phone Des er Contact Email dress Permit Type Residential Single Fa l) Residential Duplex Commercial Multifamily Industrial Catagory New ition Alteration Project Description GLt_111iel OYU ItOm [ z7L )y t +0 `�1t.�CIS • Irt •jtXX 0-hfk-5 itpo'irl,1 (irLC . Ctyy wo, t I i y Q . Mechanical Separate permits will be obtained for the following: Permits Electrical by Plumbing by Heating by Value of Job °°- $ '�J OD (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.) Payment by: Check # t 0%3 Cash Permit Fee Account I certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits 4e obtained. I acknowledge and agree to these terms. Name: ,f'y(_ 0th La. a GiZtiNQ (Please print) Date: /o A? Signatu ems: ( n't c:Lit/*�Cd S_ a4.