HomeMy WebLinkAbout0154343 - Raze 2 story house (02/05/13) CITY OF OSHKOSH No 154343
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 654 FREDERICK ST Owner CITY OF OSHKOSH REDEVELOPMENT AUTHOR'.Create Date 02/05/2013
Designer Contractor TOM VAN HANDEL CORP
Inspector John Zarate
Category * 161 -Residential Raze Plan
Type 0 Building 0 Sign O Canopy 0 Fence • Raze j
Zoning R-2PD__ 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 0 Floating Slab O Pier O Other
0 Concrete Block O Post ❑ Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/Razing the existing 2 story house. Removing all the concrete and seeding the lot.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $4,000.00 Plan Approval $0.00 Permit Fee Paid $58.00 Park Dedication $0.00
Issued By: Y\ Date 02/05/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 0704440000
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 t- enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an - sement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure a , n e- :ry appr■- als before starting such activity.
I have read and unders :nd : '-re me- '•ned infor -- .•n.
�
Signature II aj)� Date � J S� ' — -
Agent/Owner
Address 1830 E EDGEWOOD DR APPLETON WI 54913 - 7757 Telephone Number (920)735-1221
*Raze 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
0
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.
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` City of Oshkosh Oshkosh,WI P O 549B03 1130 1130
Phone: (920)236-5050
/ Fax:(920)236-5084
Building Permit Application www•ci.oshkosh.wi.us
Project f!
Address 6 Fr �rick ��
Applicant Owner Contractor Tenant Other(describe)
Owner/
Tenant Name QS N Phone
Address Email
Contractor Company Name 0 1- di 4' - 4 ' c r. Phone
Contact A ) L�r s e.V' Email
Address t? 3 0 f' Eclicjc. is:ci e.� A?l
State Credential#'s , ,
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
Description
0e—Kr?D
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
u.rI
Value of Job $ 0(D ` — (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I certt&the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be obtained I acknowledge nd agree to these terms.
Name: ( n S.c-<' (Please print) Date: ,:: — 5 - I
Signature: at