HomeMy WebLinkAbout0156116-Building (raze house) k
� CITY OF OSHKOSH No 156116
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER ,
Job Address 416 OTTER AVE Owner WELLS FARGO BANK NA Create Date 06/11/2013
Designer Contractor STATEWIDE RAZING
Inspector John Zarate
Category * 161 -Residential Raze Plan
Type � Building � Sign � Canopy � Fence � Raze �
Zoning R-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 0 Pier 0 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 FR\Raze house ;
of Work i
I
i I
i
HVAC Contractor Plumbing Contractor M P KELLY
Electric Contractor
Fees: Valuation $8,000.00 Plan Approval $0.00 Permit Fee Paid $86.00 Park Dedication $0.00
Issued By: Date 06/11/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id#0200440000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the Ciry 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 nd und rstand the o men' ned information.
Signature� ������� Date � l /� �3
AgenUOwner
Address 103 VOSTERS VIS COMBINED LOCK;WI 54133 - 1140 Telephone Number (920)766-7778
* 161-Residential Raze 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 Checkiist 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
� l,Z� � OS���S� Oshkosh,WI 54903-1130
y f Phone: (920)236-5050
� F�:(920)236-5084
Building Permit Application �W��i.oshkosh.W;.us
Project
Address
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name tti _r- C � S `� iQ G' � ��q/� � Phone
Tenant '
Address Email
Contractor p y �^`' i 2 � `�' ���`, S� �f�
Com an Name �J /�i �� �' ��� �'� /�- � Phone 7 2 G �
Contact � ���h- �/.� �%7L- Email
Address ��j � (/ 0 S' %�=� ,�' �/'/ .S %�`
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Famil esidential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project � r � �, L � �'/0 /L � //' �7�C, �i,� /�
Description
Mechanical Separate permits will be obtained for the following: /
Permits Electrical by Plumbing by 1 I�- Heating by
Value of Job
$ (Value for materials&labor is req.to ensure co sistency in accessing permit fees for all applicants.)
Payment by: Check #�(�3 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: � L "' � �1 J�/( �� (Please print) D3te: � ' �� ' �3
Signature: