HomeMy WebLinkAbout0157396-Building (basement repairs) � CITY OF OSHKOSH No 157396
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1207 N SAWYER ST Owner RALPH W HERGERT Create Date 08/23l2013
Designer Contractor ANDERSON BROS INC
inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze I
Zoning R-2 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 _ Occupancy Fee $0.00 Flood Plain Height Permit ,
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature ,SFR\Basement repairs according to attached quote. Bracing compliance to be confirmed by contractor
of Work I!
i
— �
HVAC Contra I tor Plumbin Contractor
9 --
Electric Contractor
Fees: Valuation $7,280.00 Plan Approvai $0.00 Permit Fee Paid $86.00 Park Dedication $0.00
Issued By: � Date 08/23/2013 Final/O.P. 00/00/0000
❑ Permit Voided j Parcel Id# 1601400000
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 understan entioned' formation. �
Signature �r Date 3
AgenUOwner
Address 2222 WHITE SWAN DR OSHKOSH WI 54901 - 2567 Telephone Number 920-233-4286
* 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. U�less 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 Box1130
� �lLy �f�S���S� Oshkosh,WI 54903-1130
� Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application ����.oshkosh.w�.�s
Project /�� �f�
Address � I `!, �� P� r
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name � ��'� Phone ������°��
Tenant
Address OC 3 ( ����� ��� Email
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Contractor Company Name t_�'S 3�-, � S � ��� Phone
Contact �d'� �j Email
Address �?�� ���-�"/'� S o� �C �
State Credential #'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type sidential Single Fam' Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project ��„���,,^ ��`f
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job $ �� �� 0 �
� (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 be ob ' d I ac/aaowled e and ree to these terms.
Name: ��-t� �/?��-�- `L' `�s° `� (Please print) Date: � a� l'
Signature: