HomeMy WebLinkAbout0152207 - building (kitchen bathroom remodel) CITY OF OSHKOSH No 152207
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 356 W 19TH AVE Owner LC REAL ESTATE GROUP LLC
---__ Create Date 09/10/2012
Designer
-- — Contractor CLINT ENGSTROM REMODELING
Inspector Nicole Krahn
Category * 140_Interior Remodeling
--- --— - ---- — Plan —
Type • Building Si —
Q Sign 0 Canopy O Fence 0 Raze
Zoning R-1 — Class of Const:
Size
Unfinished/Basement Sq.Ft. Rooms Height-- _ 9 _— Ft. r] Projection J
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 p
Use/Nature ISFR/remodeling kitchen and bathroom with new flooring,vanity,finish carpentry and countertops and adding a fence around the air
of Work conditioning unit outside/no structural changes being made/all work will be UDC code complying
L—
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $7,000.00 Plan Approval $0.00 Permit Fee Paid $98.00 Park Dedication
$0.00
Issued By:
Date 09/10/2012 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1405480000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the Cit of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in hi •ermit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)an. to ure an ne ssary approvals before starting such activity.
I have read a • t`rstand e ore mentioned information.
Signature 1 _ �j
v Date (/ •-_-/.1
Agent/Owner
Address 2314 PLYMOUTH ST _ OSHKOSH WI 54901 - 1729 Telephone Number (920)420-9913
* 140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500-113 on the DNR
Asbestos Program website; http://dnr.wi.gov/air/compenf/asbestos/.For additional information on hazards present in buildings see
the Pre-Demolition Environmental Checklist at http://dnr.wi.gov/org/aw/wm/publications/anewpub/WA651.pdf
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection (i.e. Footing, Service, Final, etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
` City of Oshkosh P O Box 1130
1. y Oshkosh,WI 54903-1130
Phone: (920)236-5050
Fax:(920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project 37$‘ // /`
Address 7
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name
Tenant �1r ry ar(ey Phone /q
// ?Y,
Address Email
Contractor Company Name CL 1 J_ gv�5`.(M,,-, e a ) �J� l�6 - /,�}
c�a r ►�, Phon�e' / D � / //�l
Contact C/. vi/ Zvi/f r ,v� Email 1,40.;V� / V )/41,00,69,--,.
Address 2 / V S
State Credential #'s 4?2/35-6- /Z7/3 S
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name
Designer Phone
Contact Email
Address
Permit Type Residential Single Family )) Residential Duplex Commercial Multifamily Industrial
Catagory New . ion__ Altera�ie2
Project �` n
Description �!� (1' �aor j ,.. / (/dam.�y / - ( c� c c "�1 ,r eatrcn ''yr' re.t.1ti-..i'df/'
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job
$ '` Oe)0 (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # 53/1 Cash Permit Fee Account
/certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to beob aine.. I ack owled e and agree to these terms. �7
Name: v.1L y 10 s1 (Please print) Date: 7/d 2.2
Signature: It /