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� CITY OF OSHKOSH No 155543
�
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 905 OSBORN AVE Owner BRYAN J REINKE Create Date 04/30/2013
Designer Contractor BASEMENT REPAIR SPECIALITS
Inspector Nicole Krahn
Category * 140-Interior Remodeling 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 Sq.Ft. Baths Signs
Foundation � Poured Concrete � Floating Slab � Pier � Other
� Concrete Block � Post � Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Pertnit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR\Foundation repairs to include excavating a portion of the basement walis,straighening the walis, installing support beams and
of Work backfilling with stone per the attached contract. The contractor is responsible for the engineering,design and installation of the support
beams.
I
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $7,460.00 Plan Approval $0.00 Permit Fee Paid $86.00 Park Dedication $0.00
Issued By: ��� Date 05/09/2013 Final/O.P. 00/00/0000
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❑ Permit Voided� Parcel Id# 1310130000
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 the afore mentioned information.
Signature Date .
AgenUOwner
Address 2194 S MEMORIAL DR APPLETON WI 54915 - 0000 Telephone Number 920-450-2757
* 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.
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CITY OF OSHKOSH BUILDING PERMIT APPLICATION
For 1 and 2 Famil Homes
Owner's Name Mailin Address Phone Na
� � � �)��IX�II�I''
Contractor's N e: � �iling Address p,�����f�} � Lic/Cert� Ph�No.
' [.J �I 5 ' , t �x��,, J � i j � �_� ( ) ' S
Plumbing Contracto s Name: Mailing Address Lic/Cert# Phone Na
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Electrical Contractor's Name: Mailing Address Lic/Cert# Phone No.
� ) �
HVAC Contractor's Name: Mailing Address Lic/Cert# Phone Na
� )
PROJECT LOCATION
Building Address Subdivision Name Lot No.
Zoning District Setbacks: Front Rear Left Right
ft. ft. ft. ft.
PROJECT INFORMATION
OCCUPANCY AREA CONST.TYPE STORIES NUMBER OF
�Single Family Unfinished Basement sq.ft. �Site Constructed ROOMS
-Two Family 'Manufactured C 1-Story _ Bathrooms
-Other Living Area sq.ft. �2-Story
FOUNDATION �-Bi-level _ Bedrooms
Garage sq.ft. "Tri-level
USE Ll Concrete
�' uad-level Remaining
-:Seasonal [-I Masonry ` Q Finished Rooms
�?�Permanent HEIGHT �Treated Wood �Other
-Other Height of the Structure(from final grade to the peak ;`,Other
of the roo�
ELECTRICAL PLUMBING WATER BUILDING COST �
Panel Size: Sewer Sale Price of the Project $
=� 100 Amps �-Municipal �Municipal Utility (Final cost of house,lot&labor) I
�200 Amps u Septic ��private On-Site Well
Service: Permit No. MINUS -
�Underground The Cost of the Lot $
�Overhead MINLJS -
HEAT LOSS The Cost of the Mechanicals $
Envelope Btu/Hr EQUALS =
The Cost of Conshuction $
Infiltration Btu/Hr (Fair market value which includes labor)
ENERGY SOURCE HVAC EOUIPMENT
'_�Forced Air Furnace
Choices: Natural Gas,L.P.,Oil,Elec,Solid,Solar ' l Radiant Baseboard or Panel
CJ Heat Pump
Space Htg C_�Boiler
C'Central Air Conditioning
Water Htg C Other
APPLICANTS SIGNATURE: DATE: � � �r n I I � '
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OS/OS