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Home My WebLink About0155517-Building (front door & frame) � CITY OF OSHKOSH No 155517 OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 447 W 12TH AVE Owner ROBERT C/KELLY M HILLMAN III Create Date 05/08/2013 Designer Contractor OWNER Inspector Nicole Krahn Category * 140-Interior Remodeling Plan Type � Building 0 Sign � Canopy 0 Fence 0 Raze I Zoning R-2 Class of Const: Size Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection Finished/Living Sq.Ft. Bedrooms Garage Sq.Ft. Baths Signs Foundation � Poured Concrete � Floating Slab 0 Pier � Other � Concrete Block 0 Post � Treated Wood Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit Not Required Park Dedication Not Required #Dwelling Units 0 #Structures 0 Use/Nature SFR/Installtion of new front door and frame. Replacing same size door. Work being done by Paragon Builders. of Work � I HVAC Contractor Plumbing Contractor Electric Contractor Fees: Valuation $850.00 Plan Approval $0.00 Permit Fee Paid $37.00 Park Dedication $0.00 Issued By• Date 05/08/2013 Final/O.P. 00/00/0000 ❑ Permit Voided i Parcel Id#0906800000 Cautionarv Statement to Owners Obtaininq Buildinq Permits 101.65(1 r)of the Wisconsin Statutes requires municipalities that enforce the Uniform Dwelling Code to provide an owner who applies for a building permit with a statement advising the owner that: If the owner hires a contractor to perform work under the building permit and the contractor is not bonded or insured as required under s. 101.654(2)(a),the following consequences might occur: (a)The Owner may be held liable for any bodily injury to or death of others or for any damage to the property of others that arises out of the work performed under the building permit or that is caused by any negligence by the contractor that occurs in connection with the work performed under the building permit. (b)The Owner may not be able to collect from the contractor damages for any loss sustained by the owner because of a violation by the contractor of the one and two family dwelling code or an ordinance enacted under sub.(1)(a),because of any bodily injury to or death of others or damage to the property of others that arise out of the work performed under the building permit or because of any bodily injury to or death of others of damage to the property of others that is caused by any negligence by the contractor that occurs in connection with the work performed under the building permit. *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 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 de t nd the af re entioned information. ' S - Signatur ti/ Date ' Agent/Owner Address 447 W 12TH AVE _OSHKOSH WI 54902 - 6421 Telephone Number 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. Uniess 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 I 130 � Cit,of Os�COSh Oshkosh,WI 54903-1130 ' Phone:(920)236-5050 , ` Fax:(920)236-5084 Building Permit Application W��i.oshkosh.W,.�s Project � `� 1/,, , L/� Address �� ,�lV�.�l.�� )S�1�US�(1 ��["1�Z Applicant Owner Contractor Tenant Other(describe) Owner/ Name 1�� , t�t 1ti 1C�, Phone �.a o ao3 -��5 Tenant Address �� V V • �� V'�,►'�� Emai( �l�-Q,k.S � •C Contractor Company Name ir 11 Phone �a.d '�c�-' �1 a.�' Contact (� Emai I I � r �, Address �l� 1,� l.{/ State Credential#'s � � � 3 �a 5 g ,� o y � a 5�.� , Dwe l ling Contractor Qua li f ier# Dwe l img Con trac tor# Bui l ding Con t r ac tor Regi s t r a t ion# Achitect/ Company Name Phone Designer Contact Email Address Permit Type Residenrial Single Family Residential Duplex Commercial Multifamily Industrial Catagory New Addition Alteration Project �1�-�-a�,�,(��,1� C�' 6 l�.lA� �Y�}� ��G� rr "�Y�-V�,`�Q � Description Mechanical Separate permits will be obtained for the following: Permits Electrical by Plumbing by Heating by Value of Jo6 $ �� (Value f'or materials&labor is req.to ensure consistency in accessing permit fees for all applicants.) Payment by: Check # Cash Permit Fee Account 1 certify the above information is complete and accurate. Arry deviations from the above submitted information may reguire additional permits to be oblained. 1 acknowledge and agree to these terms. Name: � 1 � � (Please print) Date: -J `�- ao �3 S ignature: