HomeMy WebLinkAbout01519454 - building (install wall to seperate room) (c?D CITY OF OSHKOSH No 151945
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3271 MOCKINGBIRD WAY Owner RUSCH HOMES LLC Create Date 08/24/2012
Designer Contractor RUSCH HOMES LLC
Inspector Adam Krause
Category * 140-Interior Remodeling Plan
Type • Building 0 Sign 0 Canopy Q 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 0 Floating Slab 0 Pier 0 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\Install wall to create bedroom separate from the family room.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor BOE ELECTRIC LLC
Fees: Valuation $4,000.00 Plan Approval $0.00 Permit Fee Paid $46.00 Park Dedication $0.00
Issued By: - = Date 08/24/2012 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 1336190000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessa .provals before starting such activity.
I have read and under e a or- = 124 ed information. / l
Signature r Date ` lL1 /-Z-
Agent/Owner
Address P 0 BOX 423 OMRO WI 54963 - 0423 Telephone Number 685-0241
* 140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500-113 on the DNR
Asbestos Program website;http://dnr.wi.gov/air/compenf/asbestos/.For additional information on hazards present in buildings see
the Pre-Demolition Environmental Checklist at http://dnr.wi.gov/org/aw/wm/publications/anewpub/WA651.pdf
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
�/ P 5 Box 1130
I City of Oshkosh Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application Hww•ci.oshkosh.wl.us
Project .-71 cf�. 1e.{/y ��/
Address cJ
Applicant caner ) on ractor T ant Other(describe)
Owner/ Name Pawl, Fl t;t/L, 1-LL-
Tenant Phone �7q- �7S0Q
Address P0 (3ci$ £12-3 (Shiro 6..1yi,3 Email
Contractor Company Name
Phone
Contact Email
Address / t'" a
State Credential#'s
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name
Designer Phone
Contact Email
__ Address
Permit Type esidential Sing e • Residential Duplex Commercial Multifamily Industrial
Catagory New Addition eration
Project Description
` /6/ CGWJ a4t',2 / sUocaJ
Mechanical Separate permits will be obtained for the following:
Permits Electrical by .2./7?4 Plumbing by Heating by
Value of Job $ 3 cz,61(4U
1.16 640.O6 (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I cerl h'the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be obtained. I acknowledge a agree to these terms p
Name: 77 Rus G A (Please print) Date: 0/6)0/!ca
Signature: 72:- /Q� "7