HomeMy WebLinkAbout0155701-Building (door) � CITY OF OSHKOSH No �5s�o�
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD :
ON THE WATER
Job Address 833 BISMARCK AVE Owner SALLY A LUND Create Date 05/17/2013
Designer Contractor PARAGON BUILDERS LLC
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Buiiding � Sign � Canopy � Fence � Raze I
Zoning R-2 Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection I
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/replace existing back door.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $450.00 Plan App�oval $0.00 Permit Fee Paid $37.00 Park Dedication $0.00
Issued By: �.�1'V�. Date 05/17/2013 Final/O.P. 00/00/0000
❑ Permit Voided'I Parcel Id#0604610000
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 pe ' pplication within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and t ecure y ne s appr als before starting such activity.
I have read nd un er and th a e ntioned information. f
Signature Date 5 ��� -r
AgenUOwner
Address PO BOX 115 BRILLION WI 54110 - 0000 Telephone Number 920-858-8724
* 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 ptease 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�,/ �f OS���S� Oshkosh,WI 54903-1130
.J .J Phone:(920)236-5050
� Fax:(920)236-5084
Building Permit Application WWW���.oshkosh.W�.�s
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Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project ��� �'�L� ��(S ��-- �i �C� 'U'- r� JJ�^-C� �G�
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job I� r
$ � (/ � (Value for 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. Any deviations from the above submitted information may require additional permits
to be obtained. I acknowledge and agree to these terms.
N3me: (Please print) Date:
Signature: