HomeMy WebLinkAbout0155540-Building �
� CITY OF OSHKOSH No �ss�o
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OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1125 N WESTFIELD ST Create Date 05/09/2013
Project Change of Use to Commercial Project Number 20130449
Owner EVERGREEN MANOR INC Plan
Contractor HEADLINER HOMES LLC
Inspector Nicole Krahn =
Designer TOM KARRELS
Category 223-Alteration O�ces, Banks, Professional Type of Plan Alt. Level 3
Zoning R-1 Square Footage
Major Occ Business Const Class Type VB
Fire Protection 0 Sprinkled � Unsprinkled � Sprinkler Design N/A
Occupancy Permit Required Flood Plain No Height Permit Not Required
Park Dedication Not Required #Dwelling Units 0 #Structures 0
� Projection Canopies _ Signs
Use/Nature
of Work
COMM/CHANGE OF USE/Converting the existing residential home into the Evergreen Home Care Office. Provide the following information noted
on the plan letter prior to the rough framing inspection:(Structural calculations for the new foundations and the new roof framing,Sections and details
of the new ramp including guard rails and hand rails,Occupancy calculations,Cabinetry elevations for Kitchen, Room finish schedule, Identify type i
and amount of insulation along with aidvapor barrier at revised roof area.) **check#3598
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HVAC Contractor UNKNOWN??? Plumbing Contractor UNKNOWN '
Electric Contractor BEEZ ELECTRIC INC
Fees: Valua' n 20,000.00 Plan Approval $0.00 Permit Fee Paid $262.80 Park Dedication $0.00
Issued By: Date 05/09/2013 Final/O.P. 00/00/0000
V � Permit Voided I Parcel Id# 1608630100
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 understan fore mentioned inform ion.
Signature l�L Date S`I /
AgenUOwner
Address 43 NATURES LN APPLETON WI 54914 - 0000 Telephone Number 920-882-4825
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.
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� Phone:(920)236-5050
Fa�c:(920)236-5084
Building Permit Application ����.oshkosh.,�.�s :
Project � i � �—j/� ���
Address , V���S
Applicant wner Contractor Tenant Other(describe)
Owner/ Name �1JeJ�-�ir���J � �I�� Phone
Tenant
Address �r t� �i—f f EL--a� Email
Contractor Company Name t.l {N� [.LC_ Phone 7��— 8�
Contact a� �� Emai 1 �(_.►�� 1'`�,—S(�J .�� =
Address
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State Credential#'s �7��� , � l ��Q�Q� ,
Dwelling Contractor Qualifier# Dwelling Contractor# uilding Contractor Registration#
Achitect/ Company Name �� ��(L�Q�L_S Phone �ZO �� —y�O
Designer _'I_ 1
Contact ��'�N mail Ja�(r� ��1�IQ�-s .�.��
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Address l� �L �1 b LV S -� I Q
Permit Ty e Residential Single Family sidential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project
Description
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Mechanical Separate permits will be obtained for the following:
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Permits Electrical by Plumbing by � Heating by N< �'
Value of Job Gl'o,o�v
$ (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 a curate. Any deviations from the above submitted infor ati n may require additional permits
to obtai ed. acknow�e and agree to thes terms.
Name: L(i(i (Please print) Date: �
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Signature: � �