HomeMy WebLinkAbout0156409-Building (weatherization) � CITY OF OSHKOSH No 156409
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3762 GLENKIRK LN Owner CLARENCE MCHONE JR/TINA KNUTH Create Date 06/24/2013
Designer Contractor ADVOCAP INC
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze I
Zoning Class of Const: Size
Unfnished/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 � 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 Mobile home/Weatherization"To include insulating and weatherstripping. Any HVAC, plumbing or electric work will require separate
of Work Ipermits from lics contractors.
I
J
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $3,527.00 Plan Approval $0.00 Permit Fee Paid $58.00 Park Dedication $0.00
Issued By: Date 06/26/2013 Final/O.P. 00/00/0000
❑ Permit Voided', Parcel Id# 1278400000
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 PO BOX 1108 FOND DU LAC WI 54936 - 0000 Telephone Number (920)426-0150
* 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.
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City of Oshkosh �
��spection Services Division �
P 0 Box I 130
Oshkosh,�54903-1130
Phone:(920)236-5050 I��/ u
Fax: (920)236-5084 O �1I�O�1 I
Buiiding Permit Application ON THE WATER
�ou are a contractor participatinQ in the Permit Fee Account System and have adequate funds check here
if vou want this processed throuQh your account �
JOB ADDRESS —��CZ ��,U fr',r�¢Y L�
OWNER T/�/l� a/G��i� —
CONTRACTOR ������/� �n c,
I am the: ❑ Owner OR ■ Contractor RECEIVEI)
USE CATEGORY .1UN 212013
�7Single Family �Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
DEPART�tE'�"f OF
Work being done: CO>1�iU�iTY DEVELOPDIEVT
❑Addition ❑Deck/Porch/Patio U Driveway/Parking
INSPECTIO�SER�'ICES DT�'iSlO:�i
❑Extemal Remodeling ❑Fence/Hedge/Kennel ❑Garage/Lltility Structure _
❑Handicap Ramp �Hot Tub/Spa ❑Intemal Remodeling
❑Sign/Canopy/Awning C Stair/Handrail �Stove/Fireplace
G Swinuning Pool ❑Wrecking Permit
f�Other �,�/eQ���E'r'lzO��L���l
Additional information, such as pl:�n submittal and approval, may be required before issuance. Fliers,
located in the hallway, may be referenced to note if any additional information is necessary.
•:• Full description of work being done: � �L c�� �-�.CI���C� �rnl�r'k or'� �'�
Anv work not included in this application is not permitted.
Value of the j ob �$ �70 '�6 _ (Value for materals and labor is required to ensure consistency in accessing permit fces for all —
applicants.)
PLEASE READ, SIGN, & DATE:
I certify the above information is compl t ta�dbe obtained. I�knowledgeramd agaee to th�e tetrms.
information may require addttional p
Name: _�n n �'� 1--GZr s��
(Please pnnt)
, ( ! / �" 1 �Q/�fJ ,�5��
Signature:
Date: 6—?0"�3
3/02