HomeMy WebLinkAbout0154718 - Building (new bathroom) CITY OF OSHKOSH No 154718
OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1130 N WESTFIELD ST Create Date 03/11/2013
Project Remodel
---- Project Number 20130371
Owner EVERGREEN MANOR INC Plan
Contractor PACKER VALLEY BUILDERS, INC
Inspector Nicole Krahn
Designer
Category 140-Interior Remodeling Type of Plan
Zoning R-1 Square Footage
Major Occ Const Class
Fire Protection 0 Sprinkled 0 Unsprinkled 1 Sprinkler Design
Occupancy Permit Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
❑ Projection Canopies Signs
Use/Nature
of Work
'COMM/Evergreen Manor UNIT MN1012/New bathroom with a walk-in shower, kitchenette cabinets, new base and patch drywall where required.
Seperation requirements will be maintained.
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $5,000.00 Plan Approval $0.00 Permit Fee Paid $65.00 Park Dedication $0.00
Issued By: LA/1/4.---- - - ------ —Date 03/14/2013 Final/O.P. 00/00/0000
❑ Permit Voided! Parcel Id# 1608640000
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 nece s pprovals ore starting such activity.
I have read and unde tand re entio information.
Signature I2 � Date 3 %
Agent/Owner
Address 2277 IRVILLE R AD OSHKOSH WI 54904 - 0000 Telephone Number 920-232-7620
* 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 0 Box 1130
OCDIA City of Oshkosh
Mir Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application www.d.oshkosh.wi.us
Project ,
Address
Applicant Ovnu titraceor Tenant Other(describe)
Owner/ Name„Tr Phone
Tenant
Address Email
Contractor
Company Name ' Y Phone
Contact . Email
Address
State Credential 4 s
Dwelling Contractor Qualifier 4 Dwelling Contractor 4 Building Contractor Registration 0
Achitect/ Company Name Phone
Designer -
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project
Description
Mechanical Separate permits will be obtained for the following:
Permits
Electrical by ,.: Plumbing by Heating by
Value of Job -
(Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
certifY the above latOrmation is complete and accurate. Any deviations.from the above submitted infi,rmotion mar require additional permits
to he obtained I acknowledge and agree to these terms.
Name: (Please print) Date: --
Signature:_,