HomeMy WebLinkAbout2013-Building (a) CITY OF OSHKOSH No 154070
OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1900-1928 S WASHBURN ST Create Date 12/28/2012
Project Office Remodel _ Project Number 20120284
Owner TODD ARNOLDUSSEN/MARK HARTZHEIM Plan Y1-3683-0113
Contractor LEACH BROS.
Inspector Nicole Krahn
Designer
Category 223-Alteration Offices, Banks, Professional Type of Plan
Zoning C-2 Square Footage
Major Occ Const Class
Fire Protection O Sprinkled O Unsprinkled 1 Sprinkler Design •
Occupancy Permit Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
C Projection Canopies Signs
Use/Nature
of Work
COMM/Office Remodel*Shea Electric adding 3 offices to existing open area and adding a storage room.
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $5,000.00 Plan Appprrovvaal� $50.00 Permit Fee Paid $65.00 Park Dedication $0.00
Issued By: Date 01/03/2013 Final/O.P. 00/00/0000
EI Permit Voidedl Parcel Id# 1316360000
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 t. -cure any necessary approvals b- •re starting such activity.
I have read diurryderstand the af6rre mentio /''Ormation.
Signatur- (/� _ . Date C
Agent/0 er
Address 2883 RUSCHFIELD DR OSHKOSH WI 54904 - 7404 Telephone Number 235-2225
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 kos G Oshkosh,WI 54903-1130
j'� I L Phone: (920)236-5050
Fax:(920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project ' ,A, )) l
Address 'L/� 5/2 6 v rf'1
Applicant Owner _Contractor____—) Tenant Other(describe)
Owner/ Name iaii e5he: 0 Phone
Tenant
Address Email
Contractor Company Name Z el L-L i /5 , C/7 57, Phone %� V �� 5
Contac 22'/ /s(L1 G C Email 6��di 6/ )..5, t �',// ' c07i•
J
Address '&50r- E- /'�
State Credential#'s , C ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration It
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addi(i�(Alteration
Project 7✓2-iv,, � Gn% , C'• e
Description
Mechanical Separate permits will be obtained for the following: t
Permits Electrical by Plumbing byc 27/ i2 " l / Heating by
Value of Job
$ G. �(_� •l�i.) (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
1
Payment by: Check # L i li$off 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 llobtaineclf. I acknowledge a d a:ree to these terms.
Name: Ci I u er , (Please print) Date: C ---.3---' /'-
Signature: — _
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