HomeMy WebLinkAbout0155756-Building � CITY OF OSHKOSH No 155756
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 219 FULTON AVE Owner TIM NETTEKOVEN Create Date 05/22/2013
Designer Contractor GREEN 8�KORTZ CONSTRUCTION LLC
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence 0 Raze �
Zoning R-2PD 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 0 Floating Slab � Pier � Other
� Concrete Biock 0 Post 0 Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR\Roofing house and garage,siding garage,fix front and back porches, update kitchen and bath+ add 1 st floor bath.All work to be '
of Work according to current code
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HVAC Contractor Piumbing Contractor
Electric Contractor
Fees: Valuation $25,000.00 Plan Approval $0.00 Permit Fee Paid $177.50 Park Dedication $0.00
Issued By: �� Date 05/22/2013 Final/O.P. 00/00/0000
❑ Permit Voided� Parcel Id# 1000210000
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 un nd the e one ormation.
Signature � Date
AgenUOwner
Address W2092 FINNIGANS RIDG FREEDOM WI 54130 - 0000 Telephone Number 920-8502998
* 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.
P O Box 1130
� �'lt � OSl���S� Oshkosh,WI 54903-1130
y f Phone: (920)236-5050
� Fax: (920)236-5084
Building Permit Application �W��i.oshkosh.W;.�s
Project � � (j r� I�bn �✓�
Address � � �
Applicant Owner Contractar Tenant Other(describe)
Owner/ Name�rl �C�-(-�e �j✓e^ Phone �Z.D Z�� �025
Tenant
Address ��6� �o vn� �� Email
Contractor CompanyName �- ��:'� 2 C��iS�f..�c����;� CCC Phone Yao 8�-'� ��c1P� ;
Contact ���z� ��CUd' 2. Email ` • �v��'�2- �Q C�. GO
Address �C� � � � c1 r G� T� �
� ppl � ` 12
State Credential#'s
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone �
Designer
Contact Email
Address
Permit Type ��tesidentia�l Single F Residential Duplex Commercial Multifamily Industrial ''
Catagory New Addition CAlteration
Project Rbr>� BI1 �D�s�_ Rd�lSr�inq 4q�'44P . �!.Y ��Onf PdT'C� FX .�a k.l�r�_/'s..
Descripdon ��
UDG�R-hC K �f C�e r� �Ba,+h r � �i i'S-F��aor� � h
Mechanical Separate permits will be obtained for the following:
Permits Electrical by — Plumbing by a Ui� e L Heating by �--
Value of Job � v� ,
��S (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. Arry deviations from the above submitted information may require additional permits
to be obtaine I ackn wledge nd agree to these terms.
Name: �Gl 4 r� ��d/�� (Please print) Date: �j � � —( �
Signature: ^/����"=3'
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