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� CITY OF OSHKOSH No 156308 4
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 503 AMHERST AVE Owner PINE MOUNTAIN INVESTMENTS LLC Create Date 06/19/2013
Designer Contractor PEPPLER REMODELING
Inspector
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze I f
Zoning R-2PD Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection
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
Park Dedication #Dwelling Units 0 #Structures 0 '
Use/Nature SFR/Bathroom remodels*on the 1 st and 2nd floors to include removing plaster and drywall and replacing flooring.One window will be
of Work hanged out and made smaller. Seperate permits required for any plumbing or electrical work.
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $8,000.00 Plan Approval $0.00 Permit Fee Paid $86.00 Park Dedication $0.00
Issued By: Date O6/20/2013 Final/O.P. 00/00/0000
❑ Permit Voided j Parcel id#0702070000
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 per ' pplication ' in an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to se re ny nece a rovals before starting such activity.
I have read and r the e tioned information. � � / 2
Signature Date /
AgenUOwner
Address W2380 COUNTY Q BERLIN WI 54923 - 0000 Telephone Number 920-361-7731
* 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
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.