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HomeMy WebLinkAbout2013-Building � CITY OF OSHKOSH No 155874 OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1900-1928 S WASHBURN ST Owner TODD ARNOLDUSSEN/MARK HARTZHEIM Create Date 05/29/2013 Designer Contractor D&J QUALITY CONSTRUCTION Inspector Nicole Krahn Category 223-Alteration Offices, Banks, Professional Plan Type � Building � Sign � Canopy � Fence � Raze I Zonin9 C�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 Not Required Park Dedication Not Required #Dwelling Units 0 #Structures 0 Use/Nature �COMM/Mitchell Insurance remodel/Adding 3 walls to add 2 rooms for offices and a counter area per plans submitted. All construction of Work shall comply with State and local building codes. Separate electrical and HVAC permits will be obtained. **check#5382 I J HVAC Contractor UNKNOWN??? Plumbing Contractor Electric Contractor UNKNOWN???? Fees: Valu tion 15,000.00 Plan Approval $50.00 Permit Fee Paid $130.00 Park Dedication $0.00 Issued By:��// 1 / Date 05/29/2013 Final/O.P. 00/00/0000 ❑ Permit Voided j Parcel Id# 1316360000 Cautionarv Statement to Owners Obtainina 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 and understa orementioned information. ��J� c5 > Signature Date � ,/�'9 /`� genUOwner Address 412 PH ANT RUN KAUKAUNA WI 54130 - 1804 Telephone Number STRIP MALL To schedule inspe tions 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 � �ll. � �S���SlL Oshkosh,WI 54903-1130 y f Phone:(920)236-5050 � Fax:(920)236-5084 Building Permit Application WWW��i.oshkosh.wi.�s Project g�c/ ,� G,/iQS� �Up.✓ �7• �,S/ykv,sl� (��, .��-! a �� Address 7 � Applicant Owner Contractor Tenant Other(describe) Owner/ Name ,l�i M-£S' �,►.- �o t�.; �vt�;'tc-��!� Phone �I� - �33 ' d��� Tenant Address �� /�IG�c.;�Q, �-Q,JF � N � Email � ,n�. � �►.�CC,,��)i�J�s,Q,e.Go Contractor Company Name �`I�� �1.�1►►-� �io r(ST���a Phone '�'l�° ' ��g'' ��.�-Z Contact �J!/�'� ��JV�aN Email Address �� ��°� L,/✓. 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 Multifamily Industrial Catagory New Addition Alteration Project a �✓o%'.✓ 3 `✓A�/f l Description �9 7 � �'c%� �- �.o�,y�S -�6 s�R<_:� -{6� a�'-�i�-.Es � 1� � � ���( 6� �"�t,a M�N� .� W���l + d R �I a �� + . - �las��R t��, Mechanical Separate permits will be obtained for the following: S c �1�,2� Permits Electrical by.Sl+t�.t ��Q�',rti c.Plumbing b�_ _ Heating by }� F A'j'�,ni G Value of Job �S ov� $ � (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.) Payment by: Check # Cash Permit Fee Account I 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. Name: ��/+� /J'l� �l��G G (Please print) Date: 45���/�� Signatur � '