HomeMy WebLinkAbout0154987 - Building (remodel sunroom) CITY OF OSHKOSH No 154987
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1271 JACKSON ST Owner ANDREW/NICULINA SMITH Create Date 04/09/2013
Designer Contractor OWNER
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type • Building _ 0 Sign 0 Canopy 0 Fence 0 Raze _ J
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 Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR\Remodel sunroom(breezway) -eliminating a door, replacing 6 windows,etc
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid $51.00 Park Dedication $0.00
Issued By: Date 04/09/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 1208270000
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 pe ' a.plication within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to se ure =ny necessary app als befo - st-I ing c■ activity.
I have read and u dy and the afore�n ed inf. ation.
Signature Date -Z1 - 9 _
Agent/Owner
Addres- 1 Z77 ( ❑Tjt Oshkosh WI 54901 - 0000 Telephone Number
* 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.
Project
Address 2 7 � C � ��t �F �`�i� ) �— 1/v 1 '4?()
Applicant Owl) r Contractor Tenant Other(describe)
CiCity G P O Box 1130
y of Oshkosh Oshkosh,WI 54903-1130
Phone: (920)236-5050
Fax: (920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address 12:7 3 \ - J Sr' d` - )-\ - Niv i k
Applicant Owi r Contractor Tenant Other(describe)
Owner/ Name NNOQIcAJJ NCV1 `--V \-4 Phone -4 2* 2-.3
Tenant
Address 1'Z_.71 k JA A� 0 -`:-5-1 Email 4 2-7 I Srn 1 0 n ç -7, V.1/. CO,-
Contractor Company Name Phone
Contact Email
Address
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type (sidential Single Ii.a3i1.1 Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteratio
Project -12c-A'Y)Ofa A__ ..-.E—e—s./1/A V W 1 NA1' JS
Description
t
(L€4 c_A 1/.35 4 --- -c inc,e__
2,e Q( --- 1.I /.( -°s► Q:1__ .
Mechanical Separate permits will be obtained for the following:
Permits Electrical by ! Plumbing by Heating by
Value of Job `'
$ (-�-C) (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 accurate. Any deviations from the above submitted information may require additional permits
to be obtaine• acknowledge and agree to these terms.
Name: 1 Oyu_ <_,1,�J G S VN ) r- (Please print) Date: 4)-(LA L c 1-013
Signature: _ > - _ z i 4 �A■