HomeMy WebLinkAbout0156103-Building (remodel) � CITY OF OSHKOSH No 156103
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1640 DEERFIELD DR Owner FREDERICK/JENNY KIRCHENWITZ Create Date 06/11/2013
Designer Contractor DEL TRITT CONSTRUCTION LLC
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy 0 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 � Pier 0 Other
� Concrete Block � Post � Treated Wood
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Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/Remodeling the lower level bathroom. Work will include installing a new vanity,shower module and resurfacing the walls. `
of Work
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HVAC Contractor Plumbing Contractor C SWEETING PLUMBING LLC
Electric Contractor
Fees: Valuation $6,000.00 Plan Approvai $0.00 Pertnit Fee Paid $72.00 Park Dedication $0.00 ;
Issued By: �1� Date 06/11/2013 Final/O.P. 00/00l0000
❑ Permit Voided'; Parcel Id# 1320260000 �
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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 secur necessary approvals before starting such activity.
I have read and u ersta d the fore menti informati . — � �— �
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Signature Date
AgenUOwner
Address 6228 COUNTY RD N PICKETT WI 54964 - 9533 Telephone Number 589-4209
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* 140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500-113 on the DNR
Asbestos Progrem 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.
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- P O Box 1130 =
� �'Zt'�,/ �f OSlGfG�slL Oshkosh,WI54903-1130 `
J J Phone: (920)236-5050 �
� Fax: (920 236-5084 =
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Building Permit Application �W���.oshkosh.W�.us
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Project / _ � �
Address l�
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Applicant Owner Contractor Tenant ther(describe �
Owner/ Name � Phone �
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Tenant �
Address � � Email
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Contractor Company Name Phone .3 7�—(a oZ�d �
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Contact � �� Email i
Address �0�2 oZrQ �j �, � � n � �
State Credential#'s , � �
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration# �
Achitect/ Company Name Phone [
Designer
Contact Email
Address
Permit Type esidential Single Family Residential Duplex Commercial Multifamily Industrial `
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Catagory New Addition lteration
Project �'
Description
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Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by ^ Heating by �
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Value of Job / °"
$ /��� (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: (Please print) Date: �--l� �3
S ignature: .��