HomeMy WebLinkAbout0157506-Building (acrylic tub) � CITY OF OSHKOSH No 157506
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1215 LOCUST ST Owner DONALD W/BONNIE M BORGEN Create Date 08/28/2013
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze _ J
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 Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication ____ #Dweiling Units 0 #Structures 0
Use/Nature SFR/remove and dispose of cast iron tub to install acrylic tub with drywall repairs - '
of Work
"'debit acct'*
- -- —- -- -- -- �
HVAC Contractor Plumbing Contractor REBATH OF CENTRAL WISCONSIN
Electric Contractor
Fees: Valuation $3,595.00 Plan Approval $0.00 Permit Fee Paid __ $58.00 Park Dedication $0.00
Issued By: �� Date 08/30/2013 Final/O.P. 00/00/0000
❑ Permit Voided I, Parcel Id# 1612530000
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 understand the afore mentioned information.
Signature Date
AgenUOwner
Address 230 N KOELLER ST OSHKOSH WI 54902 - 4109 Telephone Number (920)303-5797
* 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 Environmentai 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.
Aug 28, 2013 10:41AM REBATH CENTRAL WI 9203035935 . No, 4491 P, 4/4
, �Z� O /�/' G . P O Box 1 I30
� , �/ fas'1"�/G�SlL . Oshkosl�,W!54903-1130
J ✓ . .. . . Phone:(920)236-5050,
� • Pax: 920
( )236-5084
� � - Building Permit App]�cation. , �,�„�.��.���Sh.w�.►�
Project�' �� � S � 'r�
�aar�s Sh S�t���
Applicaet Owner Contractor Tenant Other(desc�ibe) �
O;wnEr7 . 1 � ,�/?� ' (��n
:Tenant�: . Name�.� �pt',�`7 Pl�one"I C� � ��� '� �i0
Address � (/l� f 1�.�S"� � ���' Emai(
Contractor Compari Name U � T '� � Fhane Q - -rj�C��
�0�;4,. � -
Cont�ct�_L . .,..,..�zr�ail Z F�'Tu� I��'? �! Il � JI^,
� Address �� �, . ►\ �Y V � P.� .�. )' .
State Credential#'s � ( � � , a �
Dwelling Contraccor Qualitier� T)wclling Conu�actor# Bwidmg Contractor ltegistra(ion�J
Achitect/ Company Name Ptione
Designer
Contact CmaiJ
Address
�'ermit Type Residential Single Family Residential Duplex Commercial Multifamily lndustrial
Catagory New Addition - ,A,(leration -
Project. ;, �,�'yL,p�J �° r J��� C�-� s�" 0���
Description'. - ti .1
� �"�S�aCL i��r�l ,�c �.p(a�m��' U�� � �
Mechanical Separate pern�tz{s wijl be obtaiacd for the following;
Permits �ecSac�l liY Ph�bing bY Heatin b
sy
� Value�of Job; $ C, � . :
' "' ' . (Value for materials&labor is mq.to ensure conc�ste • rmit fccs for all applicancs.)
Payment by_ Check #t � Cash Perrnit Fee Account
�I ce.tjjy the abm,e i,formarion is ca.,;plere a�rd accurnte. Arry dev;ations from the above s�rb.ni�red information may r -re addllionc(pennus
10 b� �ained. I ack,�o ledge and a�ree[o[hese�crms_ �
Name: _ �� 2. .
(Picasc print) Da[C:
. Signature: :