HomeMy WebLinkAbout0156441-Building � CITY OF OSHKOSH No 156441
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1580 BRENTWOOD CIR Owner TIMOTHY R/KATHRYN S WALLACE Create Date 06/27/2013
Designer Contractor DAVIS BUILDING SERVICE LLC
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan file
Type � Building � Sign � Canopy � Fence � Raze I
Zoning R-1 Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection I :
Finished/Living 156 Sq.Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation � Poured Concrete � Floating Slab � Pier � Other
0 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/1/2 bath 8 Laundry room'to be constructed in the basement. Seperate permits are required for plumbing,electric and HVAC �
of Work , ork.
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HVAC Contractor AMERICAN HEATING &A C CO Piumbing Contractor ABEL PLUMBING
Electric Contractor REMEDY ELECTRIC
Fees: Valuation $8,000.00 Plan Approvai $50.00 Permit Fee Paid $30.00 Park Dedication $0.00
Issued By: Date 06/28/2013 Final/O.P. 00/00/0000
❑ Permit Voided i Parcel Id# 1321900000
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 pertorm 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 an erstan e afore tio information. J
Signature Date L9 � �
AgenUOwner
Address 21 THACKERY DR OSHKOSH WI 54904 - 7140 Telephone Number (920)379-6559
* 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.
P O Box 1130
� l..lt � OS!��OS!� Oshkosh,WI 54903-1130
y ,f Phone:(920)236-5050
� Faac:(920)236-5084
Building Permit Application �W���.oshkosh.W;.us
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State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Sin Residential Duplex Commercial Multifamily Indush-ial
Catagory ew ddi ion� Alteration
Project % 1�. �-�'"� � ���.-��,r� � ,'l ��a� �,..�"�
Description �
Mechanical Separate permits will be obtained for the following:
Permits Electrical by 1«Y�• �`� , i'.cPlumbing by ��.{� � I V� _ Heating by ca, �a�
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Value of Job / ,,���
$ �c�(�T� (Value for mat ials&IabQr 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 be obtained. I acknowledge and agree to these terms.
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Name: ���C�n.c� Q` � 4: , (Please print) Date: L �
Signature:
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