HomeMy WebLinkAbout0154457-Building (bathroom remodel) CITY OF OSHKOSH No 154457
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1219 MERRITT AVE Owner LANE R EARNS/FRANCA R BARRICELLI Create Date 02/07/2013
Designer Contractor LAIB RESTORATION INC
Inspector Jerry Fabisch
Category * 140-Interior Remodeling Plan
Type • Building 0 Sign 0 Canopy 0 Fence 0 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 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
-
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit Not Required
Park Dedication Not Required #Dwelling Units _ 0 #Structures 0
Use/Nature SFR/bathroom remodel to include new drywall and insulation/nothing structural being done on this project/fixture locations staying in
of Work same spots/separate permits will need to be taken out for electrical and plumbing contractors/all work will meet state and local codes
**check#5093
1
HVAC Contractor Plumbing Contractor DAN KELLY PLUMBING
Electric Contractor WITZKE ELECTRIC INC
Fees: Valuation $4,000.00 Plan Approval _ $0.00 Permit Fee Paid $58.00 Park Dedication $0.00
Issued By: V r ' L,L Date 02/14/2013 Final/O.P. 00/00/0000
Permit Voided ' Parcel Id# 1100840000
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 before starting such activity.
I have read and understand the afore mentioned information.
Signature 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.
/� City f� P O Box 1130
1 Ci y of Oshkosh Oshkosh,WI 54903-1130
PhFax:(920)236-5050
Fax:(920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address / / �. ✓Y 1 1 i
Applicant Owner -•••C`Cntrac Tenant Other(describe)
Owner/ Name Lot v..e £ a( A c r✓u 0 Ca- PaY`( r L Phone ) 3'5 L-/ 6 5 2—
Tenant
Address [/a // /�,ry��
'( r r Email
Contractor Company Name : 1 R.?5 .iv fa. 7 c Y\ 1 wc._ Phone g ciP ->13 3 -`7 U -- f/
Contact I Q r 1�, Email /U rb Ca 1 c r 6 aP5 t(1 l '«
Address L/16) C A fiv L,Jk. 1 6 4 r Afl4-i1,
a
ff '' p 13-
State Credential#'s 70 v 1"l, l ,
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 (�lterat /
Project 7. _ 1, 1 _ a h , E t/-v OY r V 11 ` "`'"-g
Description
n x--(v t,-- 1 1,tie c, _ r o 1�1. < 1-e ,rn a`vt y' So vet_. ,
AO 5—(Vruc+v a tti 04it
Mechanical Separate permits will e obtained for the following: Ile/ a / (7/Permits Electrical by t}1 �(.Q_ Plumbing by D. h tl`G(1 Heating by 40-
Value of Job $ 1i 0 UCH - (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
l
Payment by: Check # S 04'3 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.
Name: 7i Y t La (Please print) Date: .2 -- 7 — .2- ?3
Signature:/f G"