HomeMy WebLinkAbout0154805-Building (raze duplex) � CITY OF OSHKOSH No 154805
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1718 W 9TH AVE __ Owner 9TH AND 7TH STREET LLC ___ __ Create Date 03/21/2013
Designer _ _ Contractor EGBERT EXCAVATING INC
Inspector Nicole Krahn
Category I�j�86-Raze Structure(s)-Ce�ersia�.- _ _ Plan __
I -i tn `
Type � Building 0 Sign � Canopy � Fence � Raze I
Zoning C-1_ Class of Const:
— S ize
Unfinished/Basement _ _ Sq.Ft. Rooms _ Height ___ Ft. � Projection
Finished/Living Sq.Ft. Bedrooms _ _ Stories ____ Canopies
Garage _ Sq.Ft. Baths _ _ Signs
Foundation � Poured Concrete � Floating Slab � Pier � Other
0 Concrete Block � Post � Treated Wood _ _
Occupancy Permit _ _ Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature ;GA#MVkN raze building -- --- ---
of Work I j�(.tp�eX
i
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: <�� Date 03/21/2013 Finat/O.P. 00/00/0000
❑ Permit Voided' Parcel id#0613010000
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 ap rovals before starting such activity.
I have read and un r tand the afor tione information.
Signature Date �� � �—T
AgenUOwner
Address PO BOX 462 GREEN LAKE WI 54941 - 0000 Telephone Number 920-294-6668
*285-Raze Strudure(s)-Commercial 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 cail 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 OS/L��S� Oshkosh,WI54903-1130
� Phone: (920)236-5050
Fax: (920)236-SU84
Building Permit Application ����.oshkosh.W�.us
Project
Address
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name � ., Phone
Tenant � �
Address � '��B' ��� a T!-� /4 l,�F Email
Contractor Company Name � Phone i� � �1 ��c�� 8
Contact � Emai1C Gf3�l2t E'.CC� C�/J rG{��'
� t�C. !t/�t`
Address ti � �+
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type ,J�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 �; O �
$ ��tl�. (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 accw�ate. Any deviations from ihe above submitted inforn:ation may require additional permiis
to be obtained. I acknowledge and agree to these terms.
Name: (� — � (Please print) Date: � �� 1���
Signature: �.� �