HomeMy WebLinkAbout0156303-Building (bathroom remodel): � CITY OF OSHKOSH No 156303
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1549 SANDERS ST Owner EARLIN/MILDRED E KUSSMANN Create Date 06/20/2013
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building 0 Sign � Canopy 0 Fence � Raze I
Zoning R-1 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/removal of tub to install shower
of Work
*'debit acct"'* �
i
I I ['
HVAC Contractor Piumbing Contractor
Electric Contractor
Fees: Valuation $2,965.00 Plan Approval $0.00 Permit Fee Paid $51.00 Park Dedication $0.00
Issued By: "�1�•� Date O6/20/2013 Final/O.P. 00/00/0000
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❑ Permit Voided I Parcel Id# 1305090000
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
AgenbOwner
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 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.
Jun. 19. 2013 5: 06PM . REBATH CENTRAL WI 9203035935 No. 4295 � P, 1/3
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. �t�' 0f�S�'L�20S�`L ostilcosh,WT 54903-113U
� J � . Phone:(920)23G-5050
� : • Fax: 920 236-5084 ;
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Achitect/ Company Name Phone
Designer
Contact �m��
Address
�ermit Type . �tesidential Single Family Residential Uuplex Comm,ercial Multifaqtily lndus�ial
Catagory New Addi[ion ` Alterali.on •
� I'�oject
Descriptio�p� ,n
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Mechanical Separate permiis wi11 be obtained for the following: �
Permits ..�..,:,: . . .:: :.
... .., :-F.J,�cirical_6�: . �p}umbing by_ �. Heaiing by ,
` �alue:cjf Jop� $ �s� ��. Naluc formaterials&labor is icq.to ensiae consist rmit fees for al!applicants,)
Payment by: Check # Cash Permit Fee Account '
I certify the above information.is complete e,rd pca�rare. �1�ry deviatio�rsfrom the above sub�niued inforrr,n�ion may require addirionol perniifs
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[o obtained 1'ackriowledg m�d a ee.lo Ihese terms_ •
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