HomeMy WebLinkAbout0156610-Building � CITY OF OSHKOSH No �sss�o
OSHKOSH B ING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 212 W IRVING AVE _ Owner DAVID URENEE R BECKER Create Date 07/09/2013
Designer Contractor OWNER
Inspector John Zarate
Category 111 -Single Family Addition Plan
Type � Building � Sign � Canopy � Fence � Raze I
Zoning R-2PD Class of Const:
Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection I
Finished/Living 252 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 SFR/Build new 16X12(192 sq ft)three-season room on the rear of home with 12X 5(60 sq ft)deck toward the rear yard.All work to meet
of Work �urrent code requirements.
IBeam,joist and rafter connection enginerring may be required-provided by rough inspection
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $6,000.00 Plan Approval $25.00 Permit Fee Paid $76.36 Park Dedication $0.00
Issued By: � Date 07/09/2013 FinaUO.P. 00/00/0000
❑ Permit Voided'i Parcel Id# 1004870000
Cautionarv Statement to Owners Obtaininq Buildinq Permits
101.65(1 r)of the Wisconsin Statutes requires municipalities that enforce the Uniform Dwelling Code to provide an owner who applies for a
building permit with a statement advising the owner that:
If the owner hires a contractor to perform work under the building permit and the contractor is not bonded or insured as required under
s. 101.654(2)(a),the following consequences might occur:
(a)The Owner may be held liable for any bodily injury to or death of others or for any damage to the property of others that arises out of
the work performed under the building permit or that is caused by any negligence by the contractor that occurs in connection with the
work performed under the building permit. .
(b)The Owner may not be able to collect from the contractor damages for any loss sustained by the owner because of a violation by the
contractor of the one and two family dwelling code or an ordinance enacted under sub.(1)(a),because of any bodily injury to or
death of others or damage to the property of others that arise out of the work perFormed under the building permit or because of any
bodily injury to or death of others of damage to the property of others that is caused by any negligence by the contractor that occurs
in connection with the work performed under the building permit.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the ' of Oshkosh has no auth ' nforce e ent restrictions of which it is not a party,if you perform the work '
describ d in this it 'ca' wi i eas me ,the Ci strongly urges the permit applicant to contact the easement
holder(s) nd to secu e any n cess ap bef re startin such activity.
I have re un ore ntio in ' n.
Signat e Date
AgenUOwner
Address 212 W IRVING AVE OSHKOSH WI 54901 - 4442 Telephone Number
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.
� �y P O Box1130
Clt,�f Os11A0S� Oshkosh,WI 54903-1130
� Phone.(920)236-5050
Fax:(920)236-5084
Building Permit Application WWW���.oshkosh.W;.�s
Project
Address ' � , ����y� -Q_,
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name � �
Tenant Phone 9��- 3 S' ��a :
Address ��� W• u�v� Email �
�n h uS ecc ��Ow� :
Contractor Company Name Phone
� Contact Email
�V��� Address
� � State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Ad ition Alteration
Project � S
� v� �r . L''E— �L� �c
Description
��:�P �,,. .� ��d,�S
Mec6anical Sepazate permits will be tained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job $ ^,,, ��0�,p0 (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
ained. 1 acknowledge agree o these terms.
�
Ivame: , (Please print) Date: �—Q—/3
Signat