HomeMy WebLinkAbout0155183 - Building CITY OF OSHKOSH No 155183
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2920 QUAIL CT Owner THOMAS W/SUSAN STARK Create Date 04/22/2013
Designer Contractor J&M PROFESSIONAL SERVICES,LLC.
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type • Building O Sign 0 Canopy O Fence 0 Raze
Zoning R-1 Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection
Finished/Living 132 Sq.Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation • Poured Concrete O Floating Slab O Pier 0 Other
0 Concrete Block 0 Post O Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/interior remodeling to include combining two bathrooms into one/installing a roll-in type shower for accessibility/all work will meet
of Work state and local codes/directly replacing sliding patio door with new french door same size and location as patio door
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $6,900.00 Plan Approval $0.00 Permit Fee Paid $67.00 Park Dedication _ $0.00
Issued By: Date 04/22/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id#0657060000
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 under tand e affoo mentio ed information.
Signature Date 4/-92—
/3
Agent/Owner
Address 739 WARBLER RD. HOWARDS GROVE WI 53083 - 0000 Telephone Number 920-207-6703
* 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.
ignaLure: /: �sr I
CfiliAlL.._. P Box 1130
5
City of Oshkosh Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084
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Applicant Owner (Contractor) Tenant Other(describe)
Owner/ Name ,',.,, /-'r �/' Phone 9;e0- 6-92/-//0;Z
Tenant
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Contractor Company Name �� 4-04,5,-Y,,- d,:,, /
S'rv.'c,es it Phone 92 0 2 07- G 702
Contact A_ jot /
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Address 71 7 l c� L( it'd d ,�s C�re,vt L i o " I
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State Credential#'s // 7 7 g S , , 1 19-7e SS
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type esidential Single Famil Residential Duplex Commercial Multifamily Industrial
Catagory New Addition teratio-b
Project
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Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heatin g by
Value of Job
$ ` (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I cert fy the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be o ed) I acknowledge and agree to these terms.
Name: Jos G uet / /lc c.v�t /
(Please print) Date: '7�- /‘ ` 4�c9/
Signature: _