HomeMy WebLinkAbout0152206 - Building (remodel kitchen) CITY OF OSHKOSH No 152206
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1947 HUBBARD ST Owner FEDERAL NATIONAL MORTGAGE ASSOC
--- Create Date _09/1.0/2012_
Designer — Contractor CLINT ENGSTROM REMODELING
Inspector John Zarate — —Category * 140-Interior Remodeling Plan
Type • Building 9 0 Sign 0 Canopy — ❑ Fence ❑ 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 FR/remodeling kitchen to include new flooring, paint,finish carpentry,countertops and direct replacement of exterior door/everything
of Work one per UDC code
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid — $39.00 Park Dedication $0.00
Issued By: Date 09/10/2012 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 1408920000
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 i t''s permit lication within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)an. to .ecure y ecessary approvals before starting such activity.
I have read a • u dersta t afore mentioned information.
Date 7:-/d -^/L Signature 7
Agent/Owner
Address 2314 PLYMOUTH ST OSHKOSH WI 54901 - 1729 Telephone Number (920)420-9913
* 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.
CityCityof Oshkosh Oshkosh, 5 P Box 1130
,WI 54903-1130
Phone:(920)236-5050
Building Permit Application
Fax:(920) sh.wi.us
www.ci.osh kosh.wi.us
Project e�
Address / 1 // Y2' !./J` 1ard q' -
Applicant Owner ontractor`,1'
Tenant Other(describe)
Owner/ Name j I� -
Tenant r°�v tr G�/`o Phone 70 0 �- /7/(r-.5�1,
Address
Email
Contractor Company Name Cl.h't ..',1,0)11-0.--\ f
gt- c 1 r J Phone 710 }QC- ?7/9.
Contact C/r H/ I,sire Email E s/rv,h
( }'° <op,C��
Address 2i"/ � .�Pr/ts S.
State Credential#'s /70?/3s b /22/3j'r
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name
Designer Phone
Contact
Email
Address------- _
Permit Type (Residential Single Famil idential Duplex Commercial Multifamily Industrial
Catagory New WdaTtron Alterati
Project /�/ ('�
Description ! rV CI Gtvr,�J / �a ,,."f /
e?c� U� / S Ct .-.'�
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbin g by Heating by
Value of Job 3
$ /Oo O (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # 13'11 Cash
Permit Fee Account
I cert;the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to b btalneil. I acknowledge and agree to these terms.
Name: t _41 rev._
(Please print) Date: 7'--/e, p��.
Signature: