HomeMy WebLinkAbout0153202 - Building (interior remodeling) CITY OF OSHKOSH No 153202
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1827 MITCHELL ST
— — Owner ETHON M KRUEGER
Designer Create Date 10/2.5/2012
-- Contractor OWNER
Inspector John Zarate
Category * 140-Interior Remodeling
Plan
Type • Building O Sign 0 Canopy 0 Fence 0 Raze —
Zoning R-1 — — J
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 O Floating Slab 0 Pier O Other
O Concrete Block O Post O Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain
--- --_ Height Permit
Park Dedication #Dwelling Units
_ --_ #Structures 0
Use/Nature SFR/basement remodel to include exterior walls around perimeter of finish area/insulation and vapor barrier shall be installed per UDC
of Work code/no structure changes of load bearing walls/all other work will meet local and state codes
L I
HVAC Contractor
Plumbing Contractor
Electric Contractor ---------------
Fees: Valuation $2,000.00 Plan Approval pP _ $50.00 Permit Fee Paid $32.00 Park Dedication
$0.00
Issued By: .,- ._\--- ------- -_-
Date 10/25/2.012 Final/O.P. 00/00/0000
❑ Permit Voided i Parcel Id# 1217680000
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 necessa y approvals before starting such activity.
I have read a i .. t .! - : e mentioned information.
Signature 1. � A/2 ,✓
Date 4')/cP `/,4..-
Agent/Owner
Address Oshkosh WI 54901 - 0000 Telephone Number
* 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.
P O Box 1130
City of Oshkosh Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax: (920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project //
Address / 8 -? Al/lc A /l 6)-1--
Applicant CON tie- Contractor Tenant Other(describe)
Owner I Nam Y,'rl `l� el, io1 1 t"��'UC�C/C� gob_ao — 9 sal i
Tenant // 1 Phone
Address / Sa( / -1 i t1-e_,,/2e-%/ ,S I. /q>�
Email anti t�'✓l-e Y� C�G',n4'✓Con
Contractor Company Name J
Phone
Contact Email
Address
State Credential #'s
Dwelling Contractor Qualifier It Dwelling Contractor# Building Contractor Registration#
Achitect I Company Name
Designer Phone
Contact Email
Address
Permit Type (Residential Single Fami Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteraio5 ih4,f0y
Project aC10/015 69 lOtJ/k ) a la M,/Ic/ (CV f� / /' T29 ,PSc /3 f) x'15
Description / J .J
bAS: ")1&)? -f". ci &-4/(5-'6/5 g 'r /,aJJelzvA l -cy lz/t
6111 av)-Y) 4 v / 19 ci _ _
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbin g by Heating by
Value of Job $ (9C!v
(Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # c2/0 j Cash Permit Fee Account
I certl&the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be obtained. I ackno edge and agree to these terms.
Name: c/e
)/ 2 ' I�� (Please print) Date: (9674-66---/e976/621,
Signature:, f. -, - I.' _,.