HomeMy WebLinkAbout0156305-Building � CITY OF OSHKOSH No 156305
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 860 HERITAGE TRL Owner LARRY 0/KAREN L TRITT Create Date 06/20/2013
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � 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 0 Pier � Other
� Concrete Block � Post � Treated Wood '
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
UselNature SFR/removal of tub to install shower
of Work
'*debit acct*"'
�
�
i
HVAC Contractor
Plumbin Contractor
9
Electric Contractor
Fees: Valuation $4,945.58 Plan Approval $0.00 Permit Fee Paid $65.00 Park Dedication $0.00
Issued By: ��1� Date 06/20/2013 Final/O.P. 00/00l0000
� Permit Voided� Parcel Id#0613900000
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 before starting such activity.
I have read and understand the afore mentioned information.
Signature Date
AgenUOwner
Address 230 N KOELLER ST OSHKOSH WI 54902 -4109 Telephone Number (920)303-5797
* 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 additionai 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.
Jun, 19, 2013. 5: 06PM . REBATH CENTRAL WI 9203035935 No. 4295 P. 3/3 �
i /'"�,. /" , .P0�ox1130
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� J • . S� . Phonc:(920)236-5050
Fa�c(920)236�5084.
. Bui�ding Permit Application ,. •�•�:G.�S"kos�..�.us
. pro�'ect� . . ,
Aaar�- .Y t ��(�.� U����osl� �1�a
� Appl�csnt Owner Contractor Tenant Other(describe)
Owaer�_/. Name. lrl� � . �(�.I!� . /� /
�Te�aaat: � r` � G Phone - 1 Zb����dC��
Address ��Ob. �Y('�. �tGZI � �i��DS'� S 7 7��
— Email
Contractor - � ' � � /�
Company Ntune U � 1 ) .�' phone `Z{�y� ���� - -_rj�Cj�']
Contact
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. Address • � �, � � � �l`�YeC Q � . -
. State Gedential#'s � � ���' , �
• Uvvelling Convauor Qualifier i! nwclling Cont�acWr# Bu;lding(;ontrncta•Rr�istrauon�!
A:cbitect/ Compaay Name Phone
Designer
- Contact Email
Address . .
Permit Type.. Residential Single Family . ResiJential Duplcx ,. C.ommercial 1vlultifamily Industrial
Catagory New Addition � Alteration .
Pxoject�� .
. � Aescription .
.. . w ou' ,� k�r �a�sS �nm�2
- � �
� . . �r� � e � �
Mechanicat Separate permits wil!be obtaiRed for flie fallowirig:
Permits = • .
......... . _�crrica�.hX:; Plumbing by: c� � Heating by
. Value'of Joti; $
" � � (Value for matarials 8c labor is ir,c�.to ensure consiste �rmit fces for uil applicanty.)
Payment by: � Check # Casb . Peirnit Fee Account
I eertjfy t!u vbwe informarion.is canple[e tmd accwa[e: Any devlarions fio►i�1he above submi7ted lnjorniatio�r may reguir¢nddi4o,ud pe„niis
ro be ob�a�cd !ac%wwledge mrdagree 1n Urese lerms.
Name: 0.� V1 K� . . �
. , s� � S (P�easC print) . � Date:
SigrlSp,lre: . .