HomeMy WebLinkAbout0155995-Building � CITY OF OSHKOSH No 155995
�:
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1865 CRESNIEW OR Owner MR/MRS MICHAEL K SMITH Create Date 06/05/2013 `
Designer Contractor JJ GEFFERS INC
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type � Building � Sign 0 Canopy � Fence 0 Raze I
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 0 Floating Slab � Pier � Other
� Concrete Block � Post � Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature RES/Remodeling upper bathroom to include new shower unit and flooring. No structural alterations. Separate electrical and plumbing ,
of Work permits will be obtained.
I
HVAC Contractor Plumbing Contractor
;
Electric Contractor
Fees: Valuation $5,500.00 Plan Approval $0.00 Permit Fee Paid $72.00 Park Dedication $0.00 ;
. ;
Issued By: Date 06/05/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1315980000
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 b�e��fo��a�rt�ing such activity.
I have read and rstand the afore m tione ' o-rtsf rmation.
Signature Date (��—d5^�
AgenUOwner
Address 5 WESTERN DR OSHKOSH WI 54901 - 9707 Telephone Number 231-2637
* 140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500-113 on the DNR i
Asbestos Program website;http://dnr.wi.gov/air/compenf/asbestos/.For additional information on hazards present in buildings see s
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 � OSlL��sl� Oshkosh,WI54903-1130 '
y f Phone:(920)236-5050 '
` Fax: (920)236-5084
Building Permit Application "�'"'�".°Sh�°S".W'.°S
Project �4/� �
Address _ � �� r�.,s� , �� �„
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Applicant Owner ontract Tenant Other(describe)
Owner/ Name � ��� ,�- �/o�,� .S--�,��i Phone �3,�- �02�"�
Tenant
Address ��v�.S- �r�.st ��� Gb� Email
Contractor Company Name �� �' �
,� �� 2 d�,rT Phone
Contact_ `?�S'o,-�. �� ��"P�1' Email
Address
State Credential#'s �.�-�a2 �S , , ��9/��--
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor RegisVation#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Ty Residential Single Fam' Residential Duplex Commercial Multifamily Industrial
Catagory New Addition eratio
Project �� S �w olc�.. � � �o c 7`-/
Description "� `�c� P'� �' �'`" o a e o
Mechanical Separate permits will be obtained for the following:
Permits Electrical by���Q � Plumbing by � ��c Heating by
Value of Job
$ �OC�C7 (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. Any deviations from the above submitted information may require additional permits
to be obtained. I acknowledge and agree to these terms.
Name: (Please print) Date:
S ignature: