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Home My WebLink About0156166-Building (renew #148847) � CITY OF OSHKOSH No 156166 OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1319 OSHKOSH AVE Owner DANIEL W JENSEN Create Date 06/13/2013 Designer Contractor OWNER Inspector Nicole Krahn Category * 140-Interior Remodeling Pian Type � Building � Sign � Canopy � Fence � 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 � Floating Slab � Pier � Other 0 Concrete Block 0 Post � Treated Wood Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit Park Dedication #Dwelling Units 0 #Structures 0 Use/Nature SFR/Renewing permit#148847-Remodeling 1st floor bathroom and adding 2nd floor laundry area. Drywalling and finishing. of Work i HVAC Contractor Plumbing Contractor HOMEOWNER Electric Contractor HOMEOWNER Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $30.00 Park Dedication $0.00 ' Issued By: �"'� Date 06l13/2013 Final/O.P. 00/00/0000 ❑ Permit Voided; Parcel Id# 1600250000 Cautionary Statement to Owners Obtaininq 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 wo�lc perFormed under the building permit. *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 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 se any n sary provals before starting such activity. I have read and un e an the afor entioned information. Signature Date AgenUOwner Address 1319 OSHKOSH AVE OSHKOSH WI 54902 - 2632 Telephone Number 920-948-7631 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'�,/ � OS��OSlL Oshkosh,WI54903-1130 .J f Phone:(920)236-5050 � Fax:(920)236-5084 Building Permit Application WWW��.oshkosh.W�.Us Project Address �� d�(., {�� Applicant Contractor Tenant Other(describe) Owner/ Name ��r� ��5�� Phone �ZC� �'.t� 76 3 ( Tenant Address �3�Qj C',S� �Sh Q-� Emai1C� ` �_ a� ' � Contractor Company Name Phone � Contact Email N Address State Credential#'s , , Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor RegisVation# Achitect/ Company Name Phone Designer Contact Email �� Address Permit T Residential ' mil % Residential Duplex Commercial Multifamily Industrial Catagory New Addition Alteration � Project �o-`��i�,✓L d�E%ti c�d� l ��—f G�,. fr, , ��t Description ° Mechanical Separate permits will be obtained for the following: Permits Electrical by Plumbing by Heating by Value of Job $ �n,eKi-� (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.) Payment by: Check # Cash Permit Fee Account I certi he above information is complete and accurate. Any deviations from the above submitted information may require additional permits to b b ined. o edge and agree to these terms. � Name: � (Please print) Date: () � Signature: �,,,� ��r. s P.✓i