HomeMy WebLinkAbout0156717-Building (foundation repairs) � CITY OF OSHKOSH No 156717
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1327 HAZEL ST Owner MARK R/TERI L LEVEZOW il Create Date 07/16/2013
Designer Contractor BASEMENT REPAIR SPECIALITS
Inspector Nicole Krahn
Category 112-Foundation Permit Single Family Plan
Type � Building � Sign 0 Canopy 0 Fence � Raze I
Zoning R-1 Class of Const:
Size
Unfinished/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 Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/Foundation repair to indude excavation,straightening walls and backfilling with stone. A 24'x9'section of the driveway will be
of Work replaced.
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HVAC Contrector Plumbing Contractor
Electric Contractor
Fees: Valuation $13,550.00 Plan Approval $0.00 Permit Fee Paid $149.00 Park Dedication $0.00
Issued By: � ,�/`� Date 07/16/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1509130000
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 unde d the e mentioned information.
Signature �ate� —/(-�'�
A nUOwner .
Address 2194 S MEMORIAL DR APPLETON WI 54915 - 0000 Telephone Number 920-450-2757
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
n l�l+y Of OS��OS G Oshkosh,WI 54903-1130
� �' �L Phone:(920)236-5050
F�:(920)236-5084
Building Permit Application '""`"�".°Shk°S".'"'.°S
rro;ect I 3 a / � a Z�� � (
Address
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name��'�C �'El' 1 �,� ����.c C-..� Phone �ol� ' lC) �' �7�
Tenant ,/
Address _T__�� � ��t Z e l � l Email
Contractor Company� ame -S� i1'�t'�J ,ic `� � J Phone 'yS�' ��1 ��S� .
Contact C< ��.�(' Pi_J`, � `�_ Email '�� � �x �.:r�.il 'P' i� P����I:S ,��SyN ;
Address 1 � , f'y�p� �� ' � /P_ 'o�J t `'7/�
State Credential#'s %f `� � � 1 C� , I1 y/�(T �� ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building ConVactor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project
Description �
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Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job 1
$ �'3 i�� rJ (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I certify the above information is complete and accu��ate. Any deviations from the above subnaitted information may reguire additional permits
e obtain . I acknowdedge and agree o these terms.
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Name: � �Ll'E'S E� � (Please print) Date: 7 `— ��. "l�
S ignature: