HomeMy WebLinkAbout0155286-Building � CITY OF OSHKOSH No �s52ss
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 621 MOUNT VERNON ST Owner JAMES D/ELAINE KRATZ Create Date 04/26/2013
Designer Contractor DEL TRITT CONSTRUCTION LLC
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze �
2oning R-2PD 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 � Floating Slab � Pier � Other
� Concrete Block � Post � Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR\Bath remodel
of Work
�
HVAC Contractor Plumbing Contractor C SWEETING PLUMBING LLC
Electric Contractor CUMINGS ELECTRIC INC
Fees: Valuation $3,300.00 Plan Approval $0.00 Permit Fee Paid $58.00 Park Dedication $0.00
Issued By: Date 04/26/2013 Final/O.P. 00/00/0000
� Permit Voided j Parcel Id#0401970000
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 n rstand the afore men�ned info ation.
Signature ��,���C �/��� Date �`v� — ,(.�
�— AgenUOwner
Address 6228 COUNTY RD N PICKETT WI 54964 - 9533 Telephone Number 589-4209
* 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.
• P O Box 1130
� �'lt � OS��OS� Oshkosh,WI 54903-1130
y f Phone: (920)236-5050
� Fax: (920)236-5084
Building Permit Application WWW�".°Sh�°S".W'.°S
Project / �
Address C� c� l j�� � .e �j�� � ��
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name ��^ �, vYL I /
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Address_ (�t o1 � �7� (� � 1(' VL O Email
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p y � � n Phone
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State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone 4
Designer
Contact Email
Address
Permit Typ Residential Single Famil Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project �
Description
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Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job `�
� .3�3 p p� (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.
Nanle: ( � �` �' (Please print) Date: °`�dZ� -- 1�
S ignature: �