HomeMy WebLinkAbout0152637 - Building (interior remodeling) 0 CITY OF OSHKOSH No 152637
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1216 SHORT AVE
Owner MOLLY A BUHROW
Designer
----
Create Date 09/27/2012
Contractor REBATH OF CENTRAL WISCONSIN
Inspector John Zarate
Category * 140 Interior Remodeling
Plan
Raze
Type • Building --- --------
--�Sign 0 Canopy--- - Fence
Zoning R-2
- 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 0 Poured Concrete 0 Floating Slab 0 Pier
Other
0 Concrete Block O Post 0 Treated Wood
Occupancy Permit Not Required Occupancy Fee
---- __-$OAO Flood Plain Height Permit
Park Dedication #Dwelling Units 0
#Structures 0
Use/Nature SFR/Remodeling the bathroom to include installing a new tub and wall surround. This permit does not include the plumbing work.
of Work
HVAC Contractor -----__—
Plumbing Contractor
Electric Contractor
---------------------
Fees: Valuat'on $4,800.00 Plan Approval
$0.00 Permit Fee Paid $53.00 Park Dedication
$0.00
Issued By:
Date 09/27/2012 Final/O.P. 00/00/0000
Permit Voided Parcel Id# 1206150000
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: 05PM REBATH CENTRAL WI 9203035935
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Phone:(920)236=5050
Building Permit Application Fax:(920)236-5084
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Project .
Address ., / . _ ii 1
Applicant Owner *a./ i .p, mkt
Contractor Tenant .
Other(describe)
Owner /
Name `
Tenant
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Phone a -'�d
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Contractor Ematl..
Company Name
Phone y:
Contact `
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State Credential#'s " �,`� "�
Dwelling conlrctor Qualifier#
Dwelling Contractor# 7 Building Contractor iLegistrarion#
Achitect/
Company Name
•
Phone
Contact
Email
Address .
Permit Type 41.; ;
Residential Duplex Commercial
Multifamily Industrial
Catagory New Addition
Alteration
Project
•
Description
I __
Mechanical Separate permits will be obtained for the following:
•
Permits Electrical by
Plumbing by�-�- t Heating by
Value of Job $ Z1
T (Value for materials&labor is req.to ensure COnsisienc in accessing permit fees for all a
payment by: Check # . applicants)
Cash Permit Fee Account
I certify the above information is complete and accurate. Any deviation s ft om the above-Submitted.information may require additional
be obtained I as/rnowle and agree to these terms.
Name: ' A r— • 01.0-e petmrts
(Please print) Date: a-i —
Signature: , 1J& e
Received Time Sep. 27. 2012 11 : 57AM No, 1009