HomeMy WebLinkAbout0155353-Building � CITY OF OSHKOSH No 155353
OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1130 N WESTFIELD ST Create Date 04/30/2013
Project Remodel Project Number 20130437
Owner EVERGREEN MANOR INC Plan
Contractor PACKER VALLEY BUILDERS, INC
Inspector Nicole Krahn
Designer
Category 220-Alteration Hospitals&Institutions Type of Plan
Zoning R-1 Square Footage
Major Occ Const Class
Fire Protection � Sprinkled � Unsprinkled � Sprinkler Design
Occupancy Permit Not Required Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
� Projection Canopies Signs
Use/Nature
of Work
ICOMM/Evergreen Manor UNIT MS1041/Removing one existing wall in the kitchen and installing a half wall. New bathroom with a walk-in shower,
kitchenette cabinets,new base and patch drywall where required. Seperation requirements will be maintained.
�
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $10,800.00 Plan Approval $0.00 PermitFee Paid $106.00 Park Dedication $0.00
Issued By: Date 04/30/2013 Final/O.P. 00/00/0000
❑ Permit Voided� Parcel Id# 1608640000
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 provals before starting such activity.
I have read and under n the fAre e ' a ion. .i Q �
Signature
� ' � Date
Agent/Owner
Address 2277 CIAIRVILLE ROAD OSHKOSH WI 54904 - 0000 Telephone Number 920-232-7620
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.
2013-04-26 10:35 Packer Valley/Nekimi 920 232 7622 » P 2/6
P O Box 1130
/"� Cii'of oshtos� Oshkosh.WI 54903-1130
� Phone:(920)23lr5050
Fax:(920)236-5084
Bui�diva�g Permit App�ication �-�•�hkosb.wi.na
Projcct � �1 / l
Address ��;� /� C✓d.S7''��G�(� (,��� �` /����y�
Applicant Owncr Con tor Tenant Other(describe)
Owncr/ N�c__�V e�q_ �P P/1 Phone
Tenant 6
Addrcss //�� N W QS�i C. IC.0 �mail
Contractor Company Name �aC �C�— (/e �10., �k,�/��.s_ �Mc Phonc a 3� '�'6'a O
Concact ��%� E���
Address�o� �`1 �c�-%���� /!� �G� C�S h�GS� �/� Sy 5 �y
State Credontial#'s 9.f'9 I p G � o?�9� � ;
Dvvelling Contrnclpr QwUifier# Dwelling CoricroeWr�! Buildir►g Contrpqor Registretion#
Ac6itcct/
Designcr Company Name Phone
Contact ���
Address '
Permit Typc Rcsidential Single Family Rcsidential Duplcx Commercial Multifamily Industrial
Catagory New Addition Iteratio
Pruject .�`°� ��QC�
Descripqon
Mechaoical Separate permits will be obtained for the following:
Pcrmits Electrieal by �� Plumbing by �r+wss'c�.-t Heating by
ValuC Of Job $ f�� (Valuc for macerials&labor is to cnsurc consistcn m aoxssin
�sq. cy' g permit fas for all cppliwnrs.)
Payment by: Ch�ek # Cash Permit Fee Account
1 ccrt{/,'v►hc abovc Injormat/on!s comp/e�e end accvrate. Arry devlatlons froni�hc abovc submlued lnformatlon moy require oddlliono!perml�s
ro be obmincd /acknowkdge arrd agree l01hesC 1Cr►ns.
Name: �Please print) Dat�: ��_o?�/�
Signature: