HomeMy WebLinkAbout0156307-Building � CITY OF OSHKOSH No 156307
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OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1130 N WESTFIELD ST Create Date 06/14/2013
Project Remodel Project Number 20130496
Owner EVERGREEN MANOR INC Plan
Contractor PACKER VALLEY BUILDERS, INC
Inspector Nicole Krahn
Designer
Category 220-Alteration Hospitals&Institutions Type of Plan ,
Zoning R-1 Square Footage
Major Occ Const Class
Fire Protection 0 Sprinkled � Unsprinkled � Sprinkler Design
Occupancy Permit Not Required Fiood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0 :
� Projection ! Canopies Signs
Use/Nature
of Work
COMM/MN1010/Remodeling the kitchen and bathroom per the attached scope of work. "check#34702
,
�
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valua'on $10,000.00 Plan Approval $0.00 Permit Fee Paid $100.00 Park Dedication $0.00
Issued By: � Date 06/20/2013 Final/O.P. 00/00/0000
� Permit Voided I Parcel Id# 1608640000
In the performance of this work I agree to perForm all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
I have read d the 'nformation.
Signatu Date �
AgenUOwner
Address 2277 CLAIRVILLE ROAD OSHKOSH WI 54904 - 0000 Telephone Number 920-232-7620
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
� i ���
� Cit,of Qsh�osh P O Box 1130
� Oshkosh,WI 54903-i I30
Phone:(9?O)236-505�
Faac:(920)236-SU84
Building Permit Application ����•�6kosh.w��S
Project
Address ��.��i /f/ ��,Y;� ,'�`>'�f�,,1 r ., .` � r��i'lo iU
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name
��'�������`'�` Phone
Tenartt "
Address /1..>t� �/. �„le��� �;�,� ��,�� Email
Contracfor Company Name �.�.�c�� �,, ?''�€_�, t_'��,�-�,�^ ,�''s., � phone �:,�� - i'6'.��
Contact f~;�rt���` Email
Address o�� % �� /�Gt �`r u�� �j� �� V,$�i �C�.'�'.S'.�
State Credential#'s �f'����� .,��a ����
Dwelling Coniractor Quatifier# � DweUing Contraaor tl r $nilding Contractor Registration#
Achitect i Company Name
Designer Phone
Contact Email
Address
Permit Type Residential Single Family Residentia! Dupleac Commerciai Multifamily Industrial
Catagory New Additian lteration
Project ��,,.� �� �
Description �''� �` �
Mechanica! Separate permits will be obtained for the following:
pe��� Electrica] by �c��-� Plumbing by ��s,-x us„i^�.....,- Heatin b
S Y
Value of Job $ f�� ���
(Value for matcriais&labor is neq.W ensure consistency in acctssing permit fees far atl applicants.)
Payment by: Check #1 Cash Permit Fee Account
/cerr�1he obove tnformotion is comp/eJe and accurate. Any deviations from the above sabmiued rnformalion may require oddi�iono!permiu
ro be obrained. 1 ack.rowledge and agree ro rhese terms.
Name: (Please princ) Date�
\
Signat e� ,.�
Scope of Work
Project: Evergreen Room MN1010 :
1130 N. Westfield
Oshkosh, WI
1. Remove and replace existing cabinetry and counter tops
2. Remove existing shower and install a new walk in shower with trench drain
3. Patch in drywall and maintain unit's side of one hour unit separation walls and
ceilings.
4. Remove and replace existing bathroom vanity& counter top
5. Remove light valances in bathrooms and patch drywall, electrician to install new
bar light.
6. Remove wood valiances in bedrooms and living room and patch in drywall and
maintain unit's side of 1-hour separation. `