HomeMy WebLinkAbout0157504-Building (acrylic shower base) � CITY OF OSHKOSH No 157504
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1615 MOUNT VERNON ST Owner ARVID M/ANTONELLA F CARRICK LIFE ESTATE Create Date 08/28/2013
Designer Contractor REBATH OF CENTRAL WISCONSW
Inspector John Zarate
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 #St�uctures 0
Use/Nature SFR/remove and dispose of cast iron tub to install acryic shower base with drywall repairs I
of Work
II"debit acct**
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HVAC Contractor Plumbing Contractor REBATH OF CENTRAL WISCONSIN
Electric Contractor
Fees: Valuation $4,724.00 Plan Approval $0.00 Permit Fee Paid $65.00 Park Dedication $0.00
Issued By: �n Date 08/30/2013 Final/O.P. 00/00/0000
❑ Permit Voided ' Parcel Id# 1504740000
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 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.
Aug 2�, 2013 10:40AM REBATH CENTRAL WI 9203035935 , No. 4491 P. 2/4
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` ' (� ' Oshkosh,WI.54903-1130
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. l..��y..Of OS��OS/L• . Phone:(920)�6-5050 .. .
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- � � Building Permi�t ,�pp�ication: : •�.ci.oshkosh.�:�
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Applicant Owner� Contractor � Tenani Other(describe)
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Dwelling Contractor Qualifier# Dwellin�Contraaor�t Building Contracror Regisinu;on#1
Achitect/ Company Name � Phone �
Designer C��� F ���..n_�, Email
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Peirxait Type .Residential Single Family Residential Duplex Commercial lv�ultifamily Industrial
Catagory New Addition f Alteration �
'Project .
;Descii�tion` y, - �1 . �?
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Mechanicai Separate permits will be obtai.ned for the foilowinb: � - . .
Permits. ..: .:.... :... • :: . ..: _ . ...: . .
..-�---,-:.--..... _.:. ::�Jx1GaL.b�.�+': ; . - � .�Eumbiv.a by � _ Heatin b
i�?alne�ot:�ob' $ �a.
= . (Value forma�erials 8t labor is rey.to ensure consist rmit foes for atl applicants.)
. Payment by= � .�Check �S : . . Cash Permit Fee Account
�1 ce�ti,J��he above ir fo'rmarion:is complete cmd occurate. .iny deviarionsfrom lhe above submined info»xa�on,;,ay.egurre additional pern,its
ro be obtainsd laclowwledge and agree to�hese[erms. ..: . .. . '
Name: . . _ . (Plcasc print}. . . . Date: .
Si�at�ue: .. . . . :