HomeMy WebLinkAbout0152739 - Building (interior remodeling) CITY OF OSHKOSH No 152739
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 648 WAUGOO AVE Owner ALLAN UCARLA R CHIZEK Create Date 10/03/2012
Designer Contractor ADVOCAP INC
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type • Building 0 Sign O Canopy O Fence O Raze -
Zoning R-4 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 0 Pier 0 Other
0 Concrete Block O 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 RENTAU Air sealing the home, installing attic insulation and sillbox insulation, installing a vapor barrier over the crawlspace floor,
of Work installing an exhaust fan in the bathroom and repairing the dryer venting.
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $3,792.34 Plan Approval $0.00 Permit Fee Paid $46.00 Park Dedication $0.00
Issued By: Date 10/03/2012 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id#0202490000
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 PO BOX 1108 FOND DU LAC WI 54936 - 0000 Telephone Number (920)426-0150 _
* 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.
City of Oshkosh
Inspection Services Division
'Cale
P O Box 1130
Oshkosh,WI 54903-1130
Phone: (920)236-5050 �',-I
Fax:(920)236-5084 ON THE WATER
Building Permit Application
If you are a contractor participating_ln the Permit Fee Account S stem and have ade•uate unds check here
if you want this processed through your account ii
JOB ADDRESS C54 0 W o. a •• A V 2.
OWNER A∎ aye C h ize
S / n
CONTRACTOR �vOGr�P Sn , RECEIVED 0 3 2012
I am the: ❑ Owner OR • Contractor DEPARTMENT OF
COMMUNITY DEVELOPMENT
USE CATEGORY I SPECTION SERVICES DIVISION
[lgSingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Single
Work being done:
❑Addition ❑Deck/Porch/Patio ❑Driveway/Parking
❑External Remodeling
❑Fence/Hedge/Kennel ❑Garage/Utility Structure ._
❑Handicap Ramp
❑Hot Tub/Spa ❑Internal Remodeling
❑Sign/Canopy/Awning
❑Stair/Handrail ❑Stove/Fireplace
❑Swimming Pool ❑Wrecking Permit
NOther Wea\ + 1efiz.cA171(-N
Additional information, such as plan submittal and approval, may be required before issuance. Fliers,
located in the hallway, may be referenced to note if any additional information is necessary.
+ Full description of work being done: w e ( cc d e r aPf ae Ill e
An work not included in this a. s lication is not s ermitted.
Value of the job $ 37"0.3 I (Value for materials and labor is required to ensure consistency in accessing permit fees for all
applicants.) •
PLEASE READ, SIGN, & DATE: •
submitted
I certify the above information is complete and accurate. Any deviations fr
and above
to these terms.
information may require additional permits to be obtain ed. I acknowledge
Name: A c arso,'-
(Please print)
Signature: CL„-., i.cAyu:u=--
Date: 10- 1 - 1d
3/02