HomeMy WebLinkAbout0155776-Building (parking slab) � CITY OF OSHKOSH No 155776 '
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2324 WHITE SWAN DR Owner BERNARD T/JANE A GONZALES Create Date 05/22/2013
Designer Contractor OWNER
Inspector John Zarate
Category 256-Residential Driveway 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 � F►oating Slab � Pier � Other
� Concrete Block 0 Post � Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/installing a concrete parking slab/will require approval from zoning before issuance of permit �
of Work '
I
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $1,000.00 Plan Approval $0.00 Permit Fee Paid $68.00 Park Dedication $0.00
Issued By: �� Date 05l22/2013 Final/O.P. 00/00/0000
❑ Permit Voided� Parcel Id# 1521530000
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 approvals before starting such activity.
I have read an nderstand t�he pafore entioned i rmation.
Signature /�_��y(��z,en�i�� Date a �.�,Z—/�
AgenUOwner
Address 2324 WHITE SWAN DR OSHKOSH WI 54901 - 2569 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. 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 0 Box 1130
�'�t'� �f�5����� Oshkosh,WI 54903-1130
Phone: (920)236-5050
� ' Fax: (920)2�6-5084
�ul�l,i��g ��Y.��� �ppll����o� www•ci.oshkosh.wi.us
1
Project
Address b� 3� `� <<J f���'L-- �c��r�_f�/t (���f/�lL�',�#,,��,5/
Applicant wner � Contractor 0 Tenant ❑ Other(describe)
Owner/ Name � ,{f �j� � � �,Q,�L� G�s Phone Q1a .-d.�/� �.�.�'
Tenant --
Address o2 �a`� cs1 F{��',���.,y,�� s�,►Z Email o �� S� C L
Contractor Company Name ��,�oC'1� Phone � u��
Contact Email
Address
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family ❑ Residential Duplex � Commercial 0 Multifamily ❑ Industrial
Catagory ❑ New ddition ❑ Alteration
Project
Description
- ������ ����
Mechanical Separate permits will be obtained for the following: :
Permits ❑ Electrical b ❑ PhimbinQ b
Y b y ❑ Heating by
Value of Job
$ (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: 0 Check # ❑ Cash ❑ Permit Fee Account
I certify the above inforn:ation is complete and accurate. Any deviations fi-om the above sz�bnzitted infornzation may rega�ire additional pern:its
to obtained. I c�ckno vledge and agree to these terms.
Name: .1�izis�-eG� � (Please print) Date: �c� 01� - �•�
Sib ature: �(l C'�/Q/.d�/�D L.70icJ iz.q�(i{'S