HomeMy WebLinkAbout0153492 - Building (windoes) CITY OF OSHKOSH No 153492
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 633 MOUNT VERNON ST Owner NEIGHBORHOOD HOUSING SERVICES OF SE WI Create Date 11/12/2012
Designer Contractor ASHTON CONSTRUCTION
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze
Zoning R-2PD Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection I
Finished/Living Sq.Ft. Bedrooms Stories - Canopies
Garage Sq.Ft. Baths Signs
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/remodeling to include direct replacement of windows/retuck point chimney/replace siding/installing storm doors/replace inside
of Work •oor same size and location/replace garage door/replacing sidewalk per plan/plans approved by planning divsion per permit package
HVAC Contractor Plumbing Contractor J RASMUSSEN PLUMBING INC
Electric Contractor LUXURY ELECTRIC LLC
Fees: Valuation $35,000.00 Plan Approval $0.00 Permit Fee Paid $193.00 Park Dedication $0.00
Issued By: ' Date 11/12/2012 Final/O.P. 00/00/0000
Permit Voided Parcel Id#0402510000
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 an necessary approvals •efore starting such activity.
I have read and un•-r- d t,- •r- "nti. e•%rmation.
Signature t. Arril k . iv// Date /7— —
Agent/Owner
Address 5308 COUNTY ROAD R OSHKOSH WI 54902 - 8504 Telephone Number (920)233-0870
* 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
�
j �j Oshkosh,WI 54903-1130
City of Oshkosh" Phone: (920)236-5050
Fax:Faxx:(920)236-5084
www.ci.oshkash.wi.us
Building Permit Application
Project
Address ✓ k'
Applicant Owner ontractor Tenant Other(describe)
Owner/ Name Phone
Tenant
Email r
Address ( .r/C}Aj Phone Lia) - 3;)c).S
Contractor Company Name �-�`�rJl'���5� �i
/ Email A6 /ckderre-
Address_<3M ess_ J ( 2 i?A+ R
State Credential #'s
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ C Phone
Company Name
Designer Email
Contact
A.•ress
Permit Type Resid- '.. '•t : .. Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project TLK ?6E/O✓' (7. iorvi) 10{'/./-ate a/ 61
Description 1
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Mechanical Separate permits will be obtained for the following:
Permits Electrical by LU;f LJ&i Plumbing byR45 yvi OS , Heating by
Value of Job s ✓ -.10d (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment Check # Cash Permit Fee Account
I certify 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.
(Please print) Date:
Name:
Signature: