HomeMy WebLinkAbout0155156 - Building (remove tub/shower) CITY OF OSHKOSH No 155156
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1262 W 18TH AVE Owner FREDIN FAMILY REV LIVING TRUST Create Date 04/19/2013
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type • Building O Sign 0 Canopy O Fence 0 Raze
Zoning R-3 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 O Pier O Other
O 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/Removing the existing tub/shower unit and installing a sanspa walk-in tub with a wall surround.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $10,800.00 PI n Approval $0.00 Permit Fee Paid $106.00 Park Dedication $0.00
Issued By: L4 Q Q Date 04/19/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 1307310201
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. 18. 2013 10: 18AM . REBATH CENTRAL WI 9203035935 No. 4108 P. 2/2
• City of Oshkos/2 p C Box 1130
Oshkosh,WI 54903-1130
• Phone:(920)236-5050
Fax (920)236-5084
Building Permit Application www.cLashkosh.wialS
Project I I 1
Address I� G LJ J. J{1 r
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name gill bay
Tenant Phone �) - 9
Address W.. Email
Contractor Company Name (,( gap � `
` fs Phone `ap 5I "h
l7
Contact Email 12 l n
�'(6Aj(j (�ly ,/10 2 m
Address 330 e V F,� Q 54-1q0
State Credential#'s
Dwelling Contractor Qualifier# Dwelling Contractor it Building Contractor Registration#
Achitect'/ Company Name
Designer — _ Phone
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project
Description
6f Ii ° &1fi C a. tA1101 -I►i
V ocnO
Mechanical Separate permits will be obtained for the following: •
Permits• Electrical by V �
y Plumbing by N4+. 1\1OWf - Heating by
Value of Job $ 10 ,0O
*� (Value for materials&labor is req.to ensure consiste 1.$ '. . rmit 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 : • •fined I acknowledge and agree l se
'to these terms,
Name: I tfJ U .l'C G-- (t'lease print)) Date: Olt' 1Q) (3
Signature: /a
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