HomeMy WebLinkAbout0155220 - building CITY OF OSHKOSH No 155220
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1730 ARLINGTON DR Owner ERIC W/JESSICA M KUBALEK Create Date 04/23/2013
Designer Contractor PORTSIDE BUILDERS, INC.
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 O 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 SFR1 Remodel kitchen and bath to include new cabinets,removing a closet-opening to family room larger(not bearing)
of Work
HVAC Contractor Plumbing Contractor HANSON QUALITY PLUMBING
Electric Contractor KOLLMANN ELECTRIC LLC
Fees: Valuation $19,000.00 Plan Approval $0.00 Permit Fee Paid $154.00 Park Dedication $0.00
Issued By: 11-300 %. _-� Date 04/23/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 1315890000
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 Ogre m tion • ormation.
Signature _ c:L _ Date
p
l/ Agent/Owner
Address 80 AMERICAN DR NEENAH WI 54956 - 1363 Telephone Number 920-727-4874
* 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.
i`
PO Box 1130
ill,AL City of Oshkosh Oshkosh,WI 54903-1130
Nellir Phone: (920)236-5050
Fax:(920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address ) 7 SO A RL/Ak)-roAl "e i"
Applicant Owner Contract r-) Tenant Other(describe)
Owner/ Name CRic KO►3AL 1C Phone ?20-23.c- 79/. I
Tenant
Address I73o ARLu,I47.0A -1),R, GSAKosrt wl Email
Contractor
Company f o
P Y Name RI's i w 3ou.Oeo.s Phone_ 929 9G 2- 1"s 9GI
Contact ant= cA6(4,L cxu> Email ,\d,t e n3/e be rt e portsideboi1ders, °°
1 cam-.
Address ` '80 l meort �I
icA4 - R, CC�.I AJ-1 (JI $i9s�
State Credential#'s JOLe 7YZ./(," , 6 Lib I ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name ToTq'si0(._ TS ulL•xR s Phone
1 esigner
Contact (Sivw.: As A'Sove } Email
Address
Permit Type Qesidential Single Fatnil Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Olterationl
Project �tfCll✓ a 13A1A nYcrt,ofL �ErnoDc , f
Description
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Mechanical Separate permits will be obtained for the following: ;
Permits
Electrical by Plumbing by - _ Heating by .,s'
w
Value of Job �j
$ 19, UOt) (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by ,X Check # Cash Permit Fee Account ttg
4"%.x
I certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits =-
to be obtained. 1 acknowledge and agree to these terms.
Name: (Please print) Date: ,.
Signature: