HomeMy WebLinkAbout0152596 - Building (Interior remodeling) O. CITY OF OSHKOSH No 152596
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1105 DEVONSHIRE DR Owner WILLIAM H HODGE Create Date 09/26/2012
Designer Contractor TRUGREEN
Inspector Nicole Krahn
Category * 140-Interior Remodeling
Plan
Type • Building 0 Sign 0 Canopy O Fence Raze
Zoning R-1 O —_1
Class of Const: Size _
Unfinished/Basement Sq.Ft. Rooms Height Ft. 13 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 Not Required Occupancy Fee $0.00 Flood Plain Height Permit _
Park Dedication - #Dwelling Units 0 #Structures 0
Use/Nature SFR/Insulation-adding celulose insulation over the existing insulation in the attic. No knob and tube wiring exists.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $1,300.00 Plan Approval $0.00 Permit Fee Paid $32.00 Park Dedication $0.00
Issued By: Lek--,
Date 09/26/2012 Final/O.P. 00/00/0000
LI Permit Voided I Parcel Id# 1311220000
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 rstand the of mentioned information.
Signature -=� Date
Agent/Owner
Address 2015 W SPENCER ST APPLETON WI 54914 -4640 Telephone Number (920)378-237
* 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.
Cityof Oshkosh P O Box 1130
J Oshkosh,WI 54903-1130
` Phone:(920)236-5050
Fax: (920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address 0 _ Jon X ' S
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name
Tenant /3 I(/ !L/
7 O Phone
23i -3zS 7
Address //0S /vim'X0.15 4'eke 6l` Email
Contractor Company Name --7-1"u 6-p-te,fA
Phone 92o-37r-2237
Contact Z.G c.4 ,,ic.J 1 r' Email Z / /
�GI1�n/il(J-ll-6 //K I iefn, ,Z(0,,1
Address /0/ S VV Apple70i, ff y)C-�✓' �7 �v
State Credential#'s 1 22- 7 S S 9 / 2.2.ZS /S -1 , 1 2Z J`y S y
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name
Designer Phone
Contact -----
Email
Address
Permit Type - esidential Sin Family Residential Duplex Commercial Multifamily Industrial
Catagory New • teration
Project
Description
I Sul(1 )(i on ov-er eJC;St t
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heatin g by
Value of Job $
1/3 0 0 (Value for materials&labor is r-. o ensure consistency in accessing permit fees for all applicants.)
ilirPayment by: Check # 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 obtained. I acknowledge and a ree to these terms. )
Name: 2 el,. \N/n t�f-e, ' (Please print) Date: /?-Z 6 2
Signature: ,`;
/,-