HomeMy WebLinkAbout0152649 - Building CITY OF OSHKOSH No 152649
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 619 FREDERICK ST Owner MICHAEL J/SHELLEY F MCMULLEN
— — Create Date 09/28/2012
Designer Contractor SULLI-CLAN INC
Inspector John Zarate —
Category * 140-Interior Remodeling
Plan
Type • Building Si n
O g 0 Canopy— 0 Fence 0 Raze
Zoning R-2PD 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 O Floating Slab O Pier 0 Other
0 Concrete Block O Post O Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/repairing fire damage to house including replacing headers and walls in same locations/all work will meet state and local codes/
of Work electric and plumbing need to pull separate permits for their work
HVAC Contractor -- — — Plumbing Contractor
Electric Contractor
Fees: Valuation $40,000.00 Plan Approval $0.00 Permit Fee Paid $208.00 Park Dedication $0.00
Issued By: Date 09/28/2012 Final/O.P. 00/00/0000
❑ Permit Voided) Parcel Id#0703600000
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 unde n e afore mentioned information.
Signature � Li �2� f�
Date �7
Agent/Owner
Address 3065 COMMODITY LN GREEN BAY WI 54304 - 5666 Telephone Number 920-337-1986
* 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.
G G P O Box 1130
City of Os! kosl L Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax: (920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address 6(c) F‘9 CAn�..,el7
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name S\--RAIL/ V`4���1 Phone�1
Tenant ���
Address Eck Email
Contractor Company Name SLAV Je,N-5j r w> (4;4cf�.}+',,,.`
l..-�"�� ! Phone f Zc'.--357 -) t E
Contact Y1 �✓��i�'�� Email NftCi
Address )Ci( Cc nr4ca l--v\ 17t�¢�/\ .*..� I 59'3c t-I
State Credential #'s
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project
Description 40;\ c"i O 0,W.c,- 4-0 ��6V r\f-20X iV�
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heatin g by
Value of Job $ `to/ddb OD
r (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I cert fy the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be obtained. I acknowledge and agree to these terms.
Name: (Please print) Date:
Signature: