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� CITY OF OSHKOSH No 155416
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3377 OREGON ST Owner ANOREW J/AMY L HANSEN Create Date 04/30/2013
Designer Contractor OWNER
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Inspector Nicole Krahn
Category 149-Raze detached garage,construct detached garage Plan
Type � Building � Sign � Canopy � Fence � Raze I
Zoning R-1 Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection
Finished/Living Sq.Ft. Bedrooms Stories Canopies
Garage 800 Sq.Ft. Baths Signs
Foundation � Poured Concrete � Floating Slab � Pier � Other
� Concrete Block � Post 0 Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/Raze existing detached garage,construct new*32'x 25'detached garage in rear yard.
of Work
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $20,000.00 Plan Approval $0.00 Permit Fee Paid $169.00 Park Dedication $0.00
Issued By: q,� Date 05/03/2013 Final/O.P. 00/00/0000
� Permit Voided I Parcel Id# 1413660000
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 th fore enti e inf rmation. ,
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Signature ,��' .�.i �r Date �
AgenUOwner
Address ��/ / �1����i7 .�/ Oshkosh WI 54901 - 0000 Telephone Number�`� 7 � `���c
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Pertnit 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.
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❑ Check this box if you are a contractor participating in the Permit Fee Account System and you would
like this permit processed through your account.
Project Address: _'�Z I'� O'� S�Circle one: mgle Famil Duplex
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Owner's Name: �j'IG�'I'P_GJ � �j,�S�P/7 Dayt'ime Phone #:�2Q- 379- �} 9 7�
Contractor's Name: Daytime Phone #: �yy�� �
If the contractor is applying for the permit provide the following:
Dwelling Contractor# Contractor Qualifier#
*These two credentials are required by the State of Wisconsin Safety and Buildings Division for any contractors
conducting work on residential property.
Value of the project including labor and material costs $ aG,O��_ p6
*The value for both materials and labor is required to ensure consist ncy in assessing permit fees for all applicants
even if you're doing your own work. A general rule of thumb is to double the material cost or provide an estimate
from a contractor.
Full description of the work being done:
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Electrical Work is being done by: N�
Any work not noted on this application will not be included on the permit!
The following documents are attached to this application:
❑ 2 site plans ❑ 2 Sets of Framing& Wall Bracing Plans (garage) ❑ Applicable fees' '
Please read the following and sign and date this application prior to applying for the building permit.
I cert�the above information is complete and accurate. Any deviations from the above submitted
information may require additional reviews and permits to be obtained. I acknowledge and agree to these
terms.
Signature: f�'—' Date: �f—3O'��
4 70 99 10/24/2012