HomeMy WebLinkAbout2012-Building (new bathroom) CITY OF OSHKOSH No 153423
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1016 WASHINGTON AVE Owner WALTER J SCOTT JR Create Date 11/07/2012
Designer Contractor LAIB RESTORATION INC
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type • Building 0 Sign ❑ Canopy O Fence ❑ Raze
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 • Poured Concrete O Floating Slab 0 Pier O Other
O 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 SFR/Constructing a new half bathroom on the 1st floor in an existing closet area.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $1,200.00 Plan Approval $0.00 Permit Fee Paid $32.00 Park Dedication $0.00
Issued By: k ` Date 11/07/2012 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 1100440000
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 fore starting such activity.
I have read and derstand the afore ntio information. 7.._ Z
Signature (�- t Date � •
Agent/Owner
■
Address 410 E MURDOCK AVE OSHKOSH WI 54901 - 3757 Telephone Number 233-7026
* 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 /0 /o Z,tia0A 1Y? (e./v\ G <�
Applicant /5"-W 1 1 5/) Contractor Tenant Other(describe)
Owner/ Name 6 CL ( ‘P V c o Phone 6-) 3 ''
Tenant
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6) /6' LvG49/1/ `7 (Z Email
Contractor Company Name k.(,,t.: b v✓` r►L Phone ct - 3 3 -- 7c) 6
Contact (efft L04-1.k1 Email 71.41+4 h° S fvl'a, tvYIGLri.ev, c•'=
Address /e 'c f tt. 1 4fr
State Credential#'s 71/ 2C9 7 /7%
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 71-ra111-1 vt Vtibtivr (0 h 511 ll —fi s-((-(-✓ C,
Description G
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Mechanical Separate permits will be obtained for the following: /
Permits Electrical by to' 1/ h Plumbing by O r cVts Heating by
Value of Job
$ IoZC> (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: 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 e and agre5,to these terms.
Name: /'f I 1 t (Please print) Date: /7`.-- 2
Signature: / Cs-77