HomeMy WebLinkAbout0155787-Building f � CITY OF OSHKOSH No �s5�s�
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1808 OHIO ST Owner MICHAEL A/JULIE A HERT Create Date 05/23/2013
Designer Contractor STEVE WIRTZ CONSTRUCTION
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze
Zoning R-1 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 0 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 SFR/Bathroom modifications to include installing a window,cabinets and countertops.
of Work
I
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $9,431.19 Plan Approval $0.00 Permit Fee Paid $100.00 Park Dedication $0.00
Issued By: ��� Date 05/23/2013 Final/O.P. 00/00/0000
❑ Permit Voided� Parcel Id# 1407630000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authoriry to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
I have read and understand the afore mentioned information.
Signature Date
AgenUOwner
Address N6334 TOWER ROAD FOND DU LAC WI 54937 - 7321 Telephone Number 920-923-6063
* 140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500-113 on the DNR
Asbestos Program website;http://dnr.wi.gov/air/compenf/asbestos/.For additional information on hazards present in buildings see
the Pre-Demolition Environmental Checklist at http://dnr.wi.gov/org/aw/wm/publications/anewpub/WA651.pdf
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready. ,
. ,
� Cit�of Osh�osh os�o�,WI 5�4903-1130
•�. Phone:(920)236-5050
Fa:c:(920)236-5084
Building Permit Applicat�ion ����.oshkosh.�.us .
Project
Address I�v`6 0�i 0 S�1^��' 0�l•t ILOS�1 I�l -ur�0 2�.
A�plicant Owner Contncto T�ant Other(describe)
Owner/ Name 71.1.�L C �'C�1' +'
Ten�nt Phane .3'1� ' I�J 7 3
Address 1� b`� Q(/��o cS�Y�,��' b`61�,IU�� �u l 5 yq o�
�mail
Conhaciar Company Name�`�-� f��(✓'f"�- �I,l,�.l.,(.(L�$ -�-hC. - phone C Q26� C1�3'(n 0(D�J
Comact ����►-P 1� 6 V(Z Email ���t.t x_ f'� �f�T� 1�lt�2- �
Address 1�(��3�-{ �nc�2..lr I� .l�.� ��1 C� (,�.e.�.-Lr�,C, (,2..) L �'��l�j�']
State CYedential#'s �5 ( �3 S I l� , g a-l-�pl,/3 ,
Dwelling Contracxar QualiBer# D.v�qing Contractor!/ Building Con�actor Registration#
Achltect/ Company Name Phone
Designer
Contact ����
Address
permit Type eside�al Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addivon Alteration ,
Project
bescrlpHon
��-�v v�bvv� V�/` a cl i � ��-fi i�Y1r
- 1N lv�drnnl I�n.s�, �,� }��v t Ce.�,h���(-�-r C,es1,�.vL�-c-^.I��
Mechaaical Separate permits will be obtained£or the£ollowing:
Permits �Y���L by Plumbing by ��� b
g �'
Value of�o� $ L� 1,�3( � I� ('�'�ue for materials&labor is ieq.to ens�e consistency ia accees�g permit fees for all applicauts.)
payznent by: Check # Cash Pernut Fee Account
I certtfy the above i»formarion rs complere a,rd occurare. A,ry deviaEio.,s from the above submitted information rnay reguYe additional permits
to be obtainetl. I ncbrowletlge mui agree to these terms.
Name: _ S�f�'�{.t3� l�t f�� (Please print) Date• �I a 3 I(�
Signature: � '�✓�'� '
.�
i0/T0 3Jt1d S�13Q�If18 Z121IM 31131S 98£9EZ60Z6 Wti�9�TT �TOZ/�Z/50