HomeMy WebLinkAbout0154905-Building (renew #149078) � CITY OF OSHKOSH No 154905
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 109 E SMITH AVE Owner JARROD HARVEY _ Create Date 04/02/2013
Designer Contractor J HARVEY CONTRACTING LLC
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign 0 Canopy � Fence � Raze
Zoning R-1 Class of Const:
Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection j
Finished/Living Sq.Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation � Poured Concrete 0 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 FR/Renew permit#149078/Remodeling'to include Interior remodeling gutting portions of the kitchen,bathrooms and misc other
of Work areas. No new room or wall configuration is planned at this point.
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HVAC Contractor GRANT SCHULTZ HEATING&COOLING Plumbing Contractor SOPER PLUMBING
Electric Contractor HULLAR ELECTRIC LLC
Fees: Valuation $14,0 Plan Approval $0.00 PermitFee Paid $124.00 Park Dedication $0.00
Issued By: Date 04/02/2013 Final/O.P. 00/00/0000 :
❑ Permit Voided I Parcel Id# 1515790000
In the performance of this work I agree to perform ali 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
AgenUOwner
Address 2220 SPRINGBROOK RD OMRO WI 54963 - 1815 Telephone Number 235-1130
* 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 O Box 1130
� �lt'�,/ �f OSlL��s� Oshkosh,WI54903-1130
J J Phone: (920)236-5050
� Fax: 920 236-5084
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Building Permit Application �W���.oshkosh.W;.us
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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 Alteratio
Project / �j �_ _ - , � � e �/ ,
DescripNon
Mechanical Separate permits will be obtained for the following: ,
Permits Electrical by /.1,,� o� � .i� Plumbing by /, � . Heating by �� .�/r�j ';
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Value of Job u
$ ./7 � (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
1 certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be e . c ledge and agree to thes terms.
Name: � `/C�;�e (Please print) Date: `�
Signature: