HomeMy WebLinkAbout0152636 - Building (remodel bathroom) 4111
CITY OF OSHKOSH No 152636
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1327 GRAND ST Owner PAUL W/TRACY L ANDERSON Create Date 09/27/2012
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type • Building O Sign 0 Canopy 0 Fence 0 Raze
Zoning R-2 Class of Const:
Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. E Projection
Finished/Living Sq. Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation • Poured Concrete O Floating Slab 0 Pier 0 Other
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 IS-FR/Remodeling the bathroom to include the installation of a tub and wall surround. This permit does not include plumbing work.
of Work
HVAC Contractor Plumbing Contractor AHERN-GROSS INC.
-- ----...---------- -
Electric Contractor
Fees: Valuation $3,600.00 Plan Approval $0.00 Permit Fee Paid _ $46.00 Park Dedication _ $0.00
Issued By: jL� Date 09/27/2012 Final/O.P. 00/00/0000
r-1 Permit Voided Parcel Id# 1506320000
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 understand the afore mentioned information.
Signature Date
Agent/Owner
Address 230 N KOELLER ST OSHKOSH WI 54902 - 4109 Telephone Number (920)303-5797
* 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.
Sep. 27. 2012 12 : 06PM REBATH CENTRAL WI 9203035935 No, 3157 P. 3/10
lit ofash G •P013ox 1130
J kOSF Oshkosh,WI 54903-1130
�. Phone:(920)236-5050
•
Fax:(920)236-5084
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Applicant Owner Contractor Tenant Other(describe)
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State Credential#'s
Dwelling,Contractor Qualifier it Dwelling Contractor# Building Contractor Registration f!
Achitect/ Coinpany Name_-
Phone
Contact _ Email
Address
Permit Type . idential Sin_le Farni Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project
Description
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Mechanical Separate permits will be obtained for the following: .
Permits Electrical by Plumbing by t Heating by
Value of Job $3 ---
(Value for materials&labor is req.to ensure consistenc in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I certify the above information is complete and accurate. Any deviation.rfrom the above submitted information may require additional permits
tto be obtained. I acknowf. 4- and agree , these terms.
Name: ian'e.-� (Please print) Date: q_ 1
Signature: /1A Al : 116
•
Received Time Sep. 27. 2012 11 : 57AM No. 1009
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