HomeMy WebLinkAbout2013-Buildoing CITY OF OSHKOSH No 155254
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1369 WASHINGTON AVE _ Owner PATRICK F HUGHES/S M ANDERSON Create Date 04/25/2013
Designer Contractor DAN V BINDER CONSTRUCTION
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze
Zoning R-2 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/bathroom remodel to include new flooring,drywall,cabinets/nothing structural being added or taken out/all work will meet state
of Work and local codes
HVAC Contractor Plumbing Contractor KOCH PLUMBING&HEATING INC
Electric Contractor
Fees: Valuation $5,200.00 Plan Approval $0.00 Permit Fee Paid $72.00 Park Dedication $0.00
Issued By: Date 04/25/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id#0203750000
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 u erstand the of a tione formation.
Signature � � Date v2,�—/
Agent/Owner
Address 1224 W SOUTH PARK AVE OSHKOSH WI 54902 -6642 Telephone Number (920)231-2114
* 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.
Name: 77/r/ /6/4i O, 2e (Please print) Date:
Signature:
4 P O Box 1130
CityCityof Oshkosh G L Oshkosh,WI 54903-1130
Phone: (920)236-5050
Fax:(920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address 3 l Gv
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name J dm, 4-77 Phone PO 8'2 ' c2P6
Tenant
Address Email
Contractor Company Name ,a4-aa, 6,__,,,,d,?/ Phone �� -n23/—a//y
Contact /�� 814o,4,i Email
Address ��2_4(4 Z,0, J , Per-
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project Sea- A
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by /r6te.4 Heating by
Value of Job m a
$ 0-Z.-zoo (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: 7/AZ' /6/AJ oa (Please print) Date: . 1—,.,9,..---4--/_
Signature: S`'`r1%