HomeMy WebLinkAbout0154851-Building �! CITY OF OSHKOSH No 154851
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD :
ON THE WATER
Job Address 1115 W SOUTH PARK AVE Owner THOMAS M MUELLER Create Date 03/26/2013
Designer Contractor OWNER
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence 0 Raze I
2oning R-3 Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection I
Finished/Living _ Sq.Ft. Bedrooms ___ Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation � Poured Concrete � Floating Slab � Pier 0 Other
� Concrete Block � Post � Treated Wood .
Occupancy Permit _ Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/LATE PERMIT/Remodeling the bathroom to include the removal of the claw foot tub and installation of a shower. Walls will be
of Work added for the shower area.
i :
I
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HVAC Contractor Plumbing Contractor OWNER
Electric Contractor
Fees: Valuation $200.00 Plan Approval $0.00 Permit Fee Paid $37.00 Park Dedication $0.00
issued By: � Date 03/26/2013 Final/O.P. 00/00l0000 :
❑ Permit Voided I Parcel Id# 1307150000
Cautionarv Statement to Owners Obtaininq Buildinq Permits
101.65(1 r)of the Wisconsin Statutes requires municipalities that enforce the Uniform Dwelling Code to provide an owner who applies for a
building permit with a statement advising the owner that:
If the owner hires a contractor to perForm work under the building permit and the contractor is not bonded or insured as required under
s. 101.654(2)(a),the following consequences might occur:
(a)The Owner may be held liable for any bodily injury to or death of others or for any damage to the property of others that arises out of
the work performed under the building permit or that is caused by any negligence by the contractor that occurs in connection with the
work performed under the building permit.
(b)The Owner may not be able to collect from the contractor damages for any loss sustained by the owner because of a violation by the
contractor of the one and two family dwelling code or an ordinance enacted under sub. (1)(a),because of any bodily injury to or
death of others or damage to the property of others that arise out of the work performed under the building permit or because of any
bodily injury to or death of others of damage to the property of others that is caused by any negligence by the contractor that occurs
in connection with the work perFormed under the building permit. •
*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
In the peAormance 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 unders fo me d information.
Signature Date
AgenUOwner
Address 1115 W SOUTH PARK AVE OSHKOSH WI 54902 - 6639 Telephone Number
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
� l..'lt � OS!���s!� Oshkosh,WI 54903-1130
y f Phone: (920)236-5050
� Fax:(920)236-5084
Building Permit Application �W���.oshkosh.W,.�s
Project
Address
Applicant Owner Contractor Tenant Other(describe)
Owner/ N�e v r� r'�c��� (-sz � Phone °/�D- �, 7 9- 7 9� L�
Tenant
Address � � 1 � l„� . So��-� Y'c.-�'� ��e--. Email
Contractor Company Name �r� }�U�� ��►�' Phone
Contact Email
Address
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Ty Residential �ingle'�'amil Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project C.ICe.� ^�-��- '-�v� �-a '�V►�J C�R�� �v �l�U►��
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job j'��
$�[J(/��� (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # 7d7 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
t�btained. I cknowle e and agree to these terms.
Name: 1�ft/l i'�[ !�t'l��/4 (Please print) Date:
Signature:� ,k ��u,l�G'��