HomeMy WebLinkAbout2012-Building (bathroom remodel) CITY OF OSHKOSH No 151957
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1415 RUSH AVE _ Owner JOHN C SANDBERG Create Date 08/27/2012
Designer Contractor GEFFERS REMODELING
Inspector Nicole Krahn _
Category * 140-Interior Remodeling Plan
Type • Building O Sign O Canopy 0 Fence O Raze
Zoning R-1 Class of Const: Size
Height Ft. ii Projection
Unfinished/Basement Sq.Ft. Rooms Hei 9
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/bathroom remodel including wall coverings/replacement/electrical updates/replace fixtures/no walls being added or removed/all
of Work repairs per UDC code
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $5,000.00 Plan Approval $0.00 Permit Fee Paid $53.00 Park Dedication $0.00
Issued By: Date 08/27/2012 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1609510000
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 underst d j _the afore menti fed information. 2 Z1 •�
Signature Date d
Agent/Owner
Address 208 E SNELL RD OSHKOSH WI 54901 -0000 Telephone Number 235-1422
* 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.
City of Oshkosh (/, �
Inspection Services Division
PO Box 1130
Oshkosh,WI 54903-1130
Phone:(920)236-5084 236-5050 C)/1 K
Fax:(920)236-50$4
Building Permit Application ON THE WATER
If you are a contractor participatingin the Permit Fee Account System and have adequate funds. check here
if you want this processed through your account fl
JOB ADDRESS I '1 ) S R v S
OWNER -��^ (��\'crg }�
CONTRACTOR l�e_ 3 RQ.YND •-' ge. 4-r_S
I am the: 0 Owner OR Contractor
USE CA.1 EG- R5i
% Single Family ODuplex OMulti Family DRental OCommercial DIndustriai
Work being done:
0 Addition 0 DecklPorchfPatio 0 Driveway/Parking
0 External Remodeling 0 Fence/Hedge/Kennel 0 Garage/Utility Structure
O Handicap Ramp 0 Hot Tub/Spa el Internal Remodeling
❑Sign/Canopy/Awning 0 Stair/Handrail 0 Stove/Fireplace
0 Swimming Pool 0 Wrecking Permit
0 Other
Additional information,such as plan submittal and approval,may be required before issuance. Fliers,
located in the hallway,may be referenced to note if any additional information is necessary.
•• Full description of work being done: a rY.c eL o' t c: c Li I , l l .
Any work not included in this application is not permitted.
Value of the job$ 0 0 0 (Va ue For materials and tabor is required to ensure consistency in accessing Perms fees for ati
applicants.)
PLEASE READ.SIGN.&DATE:
I certify the above information is complete and accurate. Any deviations from the above submitted
information may require additional permits to be obtained I acknowledge and agree to these terms.
Name: )a .,
rka r
Signature: 5 ,/(1,„
Tiara- �/(9 ) b