HomeMy WebLinkAbout0155476-Building (driveway) � CITY OF OSHKOSH No 155476
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 418 MERRITT AVE Owner NORMAN A/DONNA BOCK Create Date 05/07/2013
Designer Contractor OWNER
Inspector John Zarate
Category 256-Residential Driveway Plan
Type � Building 0 Sign 0 Canopy � Fence � Raze �
Zoning R-2PD Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection j
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 Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature RES/INSTALL NEW CEMENT DRIVEWAY AND OPEN PARKING IN THE REAR YARD PER SITE PLAN SUBMITTED �
of Work
I
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $5,000.00 Plan Approval $0.00 Permit Fee Paid $96.00 Park Dedication $0.00
Issued By: ��'� Date 05/07/2013 Final/O.P. 00/00/0000
❑ Permit Voided i Parcel Id#0404420000
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.
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 app before starting such activity.
I have read and understand the aforemen oned i o tion.
Signature — Date ?��%1
AgenUOwner
Address 2242 WHITE SWAN DR OSHKOSH WI 54901 - 2567 Telephone Number 235-1295
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 specifed 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
C'lt-y �f OS���S� Oshkosh,WI 54903-1130
� Phone: (920)236-5050
Fax: (920)236-5084
Building Permit Application �W���.oshkosh.w►.us
Project /�
Address �( � P�V��
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name 0 V rnG-�- � O G� �
Phone 3 7-l'I- ��/'/U
Tenant
Address � o�t,��' w�r�C ,�(,t��-- Email_ ��tirt� ��c�C � /(l�w t✓, ��;
Contractor Company Name � {� � � �' (o- /3rj`J�
co � n-�✓ Phone �-��
Contact Email
Address
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Permit T e Residential Single Family sidential Duplex Commercial Multifamily Industrial
Catagory New �ziditi�n - Alteration
Project Y � � t w Q
Descripfion
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job �jU
$ �U (Value far materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # a' Cash Permit Fee Account '
(D I certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be btained. I acknowledge and ee to these terms.
Name: �O(��-n � ��C'L (Pleaseprint) Date:
Signature• Cr�
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