HomeMy WebLinkAbout0156306-Building � CITY OF OSHKOSH No 156306
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1130 N WESTFIELD ST Owner EVERGREEN MANOR INC Create Date 06/14/2013
Designer Contractor PACKER VALLEY BUILDERS, INC
Inspector Nicole Krahn
Category 220-Alteration Hospitals&Institutions Plan
Type � Building � Sign � Canopy � Fence � Raze j
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 0 Other
� Concrete Block � Post � Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature COMM/MS1036/Remodeling the kitchen and bathroom per the attached scope of work. *'check#34702
of Work
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $14,000.00 Plan Approval $0.00 Permit Fee Paid $124.00 Park Dedication $0.00
Issued By: (���' Date 06/20/2013 Final/O.P. 00/00/0000
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❑ Permit Voided I Parcel Id# 1608640000
In the perFormance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and t ure any necessary a r fore starting such activity.
I have re and nde ta ntion informa'on.
Signature Date 2� I
AgenUOwner
Address 2277 CLAIRVILLE ROAD OSHKOSH WI 54904 - 0000 Telephone Number 920-232-7620
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection (i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not perFormed within two business days from the time the project is ready. '
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(Z���
� ��t��f��1ll��s� P O Box 1130
� Oshkosh,WI 54903 !t30
Phone:(920)236-5050
Fa�c:(920)236-5084
Building Permit Application ���;.�6kos6.,�.u$
Project
Address /,�,?(� �/ t� . :
1,.��'��. �'}%r,� l '�Gj-=b"
Applicant Owner Contractor Tenant Other(describe)
Uwner! Name_ .u•rc;,
Tenant �` �"�'' Phone
Address ���C' ,�''�,! l•�,��,,^-� �`;�: ��:� Email
Contracior
Com pany Name �c�c.��� �`/'� �,1�� l�"'
`c a :�„�r s�,,C Phone ��.s� "����
Contact �,ka�v`� Email
Address c,����� C�;.-�,�I'�(.� I[�� �.5'�/<`,C S�i
Siate Credentiat#'s f-��.��� � ,�?�+ '?
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Dwelling Contractor Qualifier# � Dwetting Contrador# � Bui(dmg Contractor Registration#
Achitect 1 Company Name
Designer Phone
Contaci
Emai!
Address
Permit Type Residential Singte Family Residentia! Duplex Commercial Multifamily Industrial
Catagory New Addition Alterat�on'�
Project r^ �
Description ��� � �`�' ��
Mechanical Separate permits will be obiained for the following:
Permits Efectrical b
Y �_ �'�`� Plumbing by �a.s.�,.,,,s�,�,.,,. Heating by
Yalue of Job � �G�r �Q�
(Value for matetials&labor is req.to ensure consistcrecy in accessing permit fees fo�all applicants.)
Pa yment b y: C h ec k # Cash Permit Fee Accouni
—_
/certifv the above irtfarmation is complete arrd�tccurote. Any deviations from the above submi�ted information may require addilional permits
to be obtarned. 1 anrv�owledge and agree lo these terms.
Name:
{Please print) Date: .
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Signatu •
Scope of Wark
Project: Evergreen Room MS1036
1130 N. Westfield
Oshkosh, WI
1. Remove one existing kitchen wall with pocket door and cut down a second wall to
a %2 wall.
2. Rebuild kitchen soffits as needed
3. Remove and replace existing cabinetry and counter tops
4. Remove existing shower and install a new walk in shower with trench drain
5. Patch in drywall and maintain unit's side of one hour unit separation walls and
ceilings.
6. Remove and replace existing bathroom vanity & counter top
7. Remove light valances in bathrooms and patch drywall, electrician to install new
bar light.
8. Remove wood valiances in bedrooms and living room and patch in drywall and
maintain unit's side of 1-hour separation.