HomeMy WebLinkAbout2013-Building (break room alteration) � CITY OF OSHKOSH No 156434
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OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1506-1518 S MAIN ST Create Date 06/27/2013 •
Project Industrial alteration Project Number 20130512
Owner BLENDED WAXES PROPERTIES LLC Plan
Contractor R J ALBRIGHT INC.
Inspector Nicole Krahn
Designer
Category 211 -Alteration Industrial Type of Plan
Zoning M-2 Square Footage
Major Occ Const Class
Fire Protection � Sprinkled � Unsprinkled � Sprinkler Design
Occupancy Permit Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
❑ Projection I Canopies Signs
Use/Nature
of Work
IND/altered floor space per state approved plans/break room alteration/all work will meet state and local codes
I
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $22,000.00 Plan Approval $0.00 Permit Fee Paid $121.68 Park Dedication $0.00
Issued By: � Date 06/27/2013 Final/O.P. 00/00/0000
� Permit Voided I Parcel Id#0305310000
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 un and the afore mentione formation.
Signature � � Date C��c�� �3
AgenUOwner
Address 5711 GREEN VALLEY RD OSHKOSH WI 54904 - 9700 Telephone Number 231-8635
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.
P O Box 1130
� �'lt � �S��OS� Oshkosh,WI 54903-1130
y f Phone: (920)236-5050
� FaY: (920)236-5084
Building Permit Application WWW���.oshkosh.W�.us E
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State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name ��� � Phone
Designer `
Contact �Q7�'1 �� - Email �
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project _1`��,,�i'c� �-PI�-U-� ,�1��/J-�iY_rti— #
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job
$��1,��-�� (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check #�� Cash Permit Fee Account
1 certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to b obtained. I acknowledge and agree to these terms.
Name: (Please print) Date: ��7��
S ignature: '