HomeMy WebLinkAbout0155161 - Building CITY OF OSHKOSH No 155161
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1942 MONTANA ST Owner GREGORY R/AMANDA J POTRATZ Create Date 04/19/2013
Designer Contractor OWNER
Inspector Nicole Krahn _
Category * 140-Interior Remodeling Plan
Type • Building 0 Sign ❑ 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 0 Floating Slab 0 Pier 0 Other
0 Concrete Block O Post O Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature RES/Gutting the bathroom to the studs. Will not be moving or adding walls. Will insulate and install new drywall and finish materials.
of Work Separate elec. &plmg.permits will be obtained.
HVAC Contractor Plumbing Contractor WAITERS PLUMBING
Electric Contractor SECKAR ELECTRIC CO INC
Fees: Valuation $4,000.00 Plan Approval $0.00 Permit Fee Paid $58.00 Park Dedication _ $0.00
Issued By: Date 04/19/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1406820000
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 cessary p ovals before starting such activity.
I have read and unde t the afor tioned information.
Signature
/117 �--� Date Vlr 7----S
AgenUOwner
Address 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.
PO Box 1130
0 """ , City of Oshkosh Oshkosh,WI 5)903-1130
moor Phone: 920 236-504
Fax:(920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address 19 LL2- MoA" Sf
Applicanter) Contractor
_ Tenant Other(describe) c�
Owner/ Name G Y0A Phone d3 j`(c.0 p`,
Tenant 1 q JJa��n r
Address
/ / {vIOY_.j(�'..(t al— Email s\y7A '�LL C'S II•C'C'tk
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Contractor Company Name Kr('S\- -6. - Phone W-0 2.I _ NO
Contact 3k(\C Email
Address f) Cq/kcq L:ICI a VeLIS Cd Szvci 3
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name �� Phone
Designer
Contact Email
Address
Permit Type `sidenttal Single Famil Residential Duplex Commercial Multifamily Industrial
Catagory New Addition
Project 0\-. bc,4-1t,1 w., , ;vs )( Sro k I Stu Gc-11,,,,17
Description ,- e c--f- L\ e....-.3 I ct 5 j#
CW-°=v— Vi _ 1'x+55/64
t o f (J0¢1 {k 0 i.S 4 A L cLtx r.
Mechanical Separate permits will be obtained for the following: l
Permits Electrical by 5�1 ( jt-i Plumbing by 1JA-1-r-^i S k,^-\�‘.) Heating by
Value of Job $ -t /�� (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 obtained. I acknowledge and agree to these terms. ���
Name: Y Q: �xiG - (Please print) Date: /09•01-5
Signature:
1-...