HomeMy WebLinkAbout2013-Building CITY OF OSHKOSH No 155056
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1203 WITZEL AVE Owner STEPHEN P VANMUN Create Date 04/16/2013
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector Nicole Krahn _
Category * 140-Interior Remodeling Plan
Type • Building 0 Sign O Canopy 0 Fence O Raze
Zoning R-1 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 O Floating Slab 0 Pier O Other
0 Concrete Block O Post 0 Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/Tearing out the cast iron tub and replacing with a shower base and wall surrounds. Building a wall to fit the shower base.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $6,622.99 Plan Approval $0.00 Permit Fee Paid $79.00 Park Dedication $0.00
Issued By: \j/N—/ Date 04/16/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id#0607830000
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 approvals before starting such activity.
I have read and understand the afore mentioned information.
Signature Date
Agent/Owner
Address 230 N KOELLER ST OSHKOSH WI 54902 - 4109 Telephone Number (920)303-5797
* 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.
Apr. 15. 2013 10: 20AM REBATH CENTRAL WI 9203035935 No. 4071 P. 1/1
/� P O Box 1130
City of Os Lkosh, Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application tivww,«,oshkosh.wi.us
Project
Address 1 A16 v 3 V 1 e- FlAtei) U.xJ •
Applicant Owner Vain Tenant Other(describe) n �+,
Owner/ Name 5 h V a C t Phon[gZO) 2-o l9
Tenant l
Address 1 lb Witzei AvexuAk, Email 'Contractor Company Name tia"01 o- - Ce f r' I W Ctprisi hone (Cle2,0)-36.3 - 5/97
Contact 1-17.- 1-uci.re. Email L120 rcbex+h cey.k►►r.J• `cam
Address 7.- 0 t \0 M\-G•r B-}"
State Credential#'s 1 0 4 S5 , i 24 7 v91 , •
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 (Alteration)
Project 1-Z0a (51a el l* 19-6Y t\.07 (bele ol. w;t' 5ka ne-
oP don
e, ' wo U Stxrr�uuS - PAtithit3a wCi(
2i ".x -714011 ft-I- -shower beat. . ._
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Y Heating by
Value of Job $ ) (Value for materials&labor is re q.to ensure consistency in accessing Q q y g ptlnnit fees for all applicants.)
Payment by: Check # Cash ermit Fee Account
I certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be btahred I ackn wledge and agree to these terms.
Name:0 a..e.lil 11 Mkt) (Please print) Date: 4/1 Se ii Signat