HomeMy WebLinkAbout0152475 - Building (interior remodeling) CITY OF OSHKOSH No 152475
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1915 FABRY ST Owner NORMA J GOFF Create Date 09/19/2012
Designer — Contractor LAIB RESTORATION INC
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type • Building
g O Sign O Canopy O Fence O Raze
Zoning R-1 Class of Const: Size
Unfinished/Basement - Sq.Ft. Rooms Height Ft. ❑ Projection i
Finished/Living Sq. Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths
_- -- - —. - Signs
Foundation 0 Poured Concrete O Floating Slab O Pier O Other
O 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 (RES/Creating a larger laundry room area by garage entrance. Extending existing walls and adding non-loadbearing walls. Separate
of Work !elec. and plumbing permits will be obtained. All construction shall comply with State and local building codes.
II
HVAC Contractor Plumbing Contractor KURT ZE_NTNER&SONS INC
Electric Contractor FAITH TECHNOLOGIES, INC.
Fees: Valuation $5,000.00 Plan Approval $0.00 Permit Fee Paid $53.00 Park Dedication _ $0.00
Issued By: Date 09/19/2012
Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1412390000
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 ea ement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any essary pro s before starting such activity.
I have read and and a of a ed inflmation.
Signature �j A
Date
Agent/Owner
Address 410 E MURDOCK AVE OSHKOSH WI 54901 - 3757 Telephone Number 233-7026
* 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.
0 P5 Box 1130
City of Oshkosh Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax: (920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address _j lit 1
Applicant Owner �/� sContracto/� Tenant Other(describe)
Owner/ Name ' 1 1�C.%t_il G4 vt l� 1U C�d �,�vl Phone___ H6 ^ ,5� (�'47
Tenant v
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Address I Cl t S 6, S
Email
Contractor Company Name // L c
P Y i•'•C.i t el'7 C'7 C' • tti4--, -711 C Phone "1--t,) F O7J3? _ v4)
011a'"\-"k-- V r--,� r 14
Contact
Email Nag, 6Cd lit I I"ef4lj,,,d-1t.
Address 11 (0 c. AS J 144 Lv'' i CC// c4(y.
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State Credential #'s
Dwelling Contractor Qualifier 4 Dwelling Contractor 4 Building Contractor Registration 4
Achitect/ Company Name
Designer Phone
Contact Email
Address
Permit Type esidential Single Eamily___..)Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration`'
Project _ L%J t' ?2A. SV - %K.'?—
Description 'p `_ J j
1\�,'. ,0 ece,t/L .- It � pac.T r 'C C-t --- (,,. ci S
Mechanical Separate permiq_vvill l_be obtained for the following:
Permits Electrical by i'ck kG r—
Y t�v1G��,�P,bu�bing by ��ti-t"1'L�� Heating by �y4-1,�a1 -6/^
Value of Job $ 7(%w , a� �►►++
J (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # `7" `f ill Cash Permit Fee Account
I certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be obtain ask�tow dge agree to these terms.
Name: 6/'
(Please print) Date: 7 "'( " l�
Signature: 14Ct'- t