HomeMy WebLinkAbout0155075 - Building (basement remodel) CITY OF OSHKOSH No 155075
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1013 N LARK ST Owner BERNARD L SORENSON SR REV LIVING TRUST Create Date 04/16/2013
Designer Contractor OWNER
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type • Building 0 Sign 0 Canopy 0 Fence 0 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 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/Basement remodel*to include adding a bathroom. there will only be 2 walls partially finished and a curtain used to screen the
of Work area. An exhaust fan will be required.
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $500.00 Plan Approval $50.00 Permit Fee Paid $37.00 Park Dedication $0.00
Issued By: Date 04/17/2013 Final/O.P. 00/00/0000
I Permit Voided I Parcel Id# 1602410000
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 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.
APR-16-2013 01:11P FROM:DRUCKS PLUMBING C920)722-0651 TO:2365084 P.3
CityCity of OShkosii P Box 1130
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Building Permit Application Fax:(920)236-5084
WWW.ci.osh kOSh.WI.us
Project
Address
Applicant Owner Contractor Tenant
Other describe) o Ilo.c
Owner/ Name
Tenant i� 9 re a�Co.�l Phone
K2A -0000
Address / 1l3 , Lam 5 -
Email
Contractor Company
P Y Name rNle SoraNSo.c) Phone
Contact
Emai 1
Address
State Credential#'s
Dwelling Contractor Qualifier# Dwellin Contractor#
8 Building Contractor Registration#
Achitect/ Company Name
Designer Phone
Contact
Email
Address
Permit Type residential Single Family Residential Duplex lex Commercial Multifamily Industrial Cato o ry New Addition
rati• •
Project
Description
iJ rz l �^+
U o l d P i �017.t5 Ls 1( t•+�Y 5 4 p,,v Jam.) fp a S erts.c,e,,
Mechanical Separate permits will be obtained for the following:
Permits Electrical by ,or I-re $ Plumbing by DivelcS Heating by
Value of Job $ Soo ='
(Value for materials&labor is req.to ensure consisten in accessing permit fees for all applicants.)
Payment by: Check # Cash
'emit Fee Account �r
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: Lt ur gex. i!f r 43/
(Please print) Date: �{— t (o— /3
Signature: (“4,4114W147
APR-16-2013 01:11P FROM:DRUCKS PLUMBING C920)722-0651 TO:2365084 P.4
re.0 zP
OS-N FCo Sr! < (-. L 54-1co2
(,, V wit( (sor,f y r DRY e
om'
�a, � 're 0.k�cc�a1ls a
NI
• ' V
a
___43f.....Verf--
•
`) 0
I
I
t4 3 ( 01: