HomeMy WebLinkAbout0156942-Building (driveway) � CITY OF OSHKOSH No 156942
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 527 AMHERST AVE Owner MEHDI/DIANE MOHAMMADIAN Create Date 07l29/2013
Designer Contractor JS CONSTRUCTION
Inspector John Zarate
Category 256-Residential Driveway Plan
Type � Building 0 Sign 0 Canopy � Fence � Raze �
Zoning R-2PD Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection ''
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/Replace existing concrete drive per site plan submitted
of Work
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $1,900.00 Plan Approval $0.00 Permit Fee Paid $75.00 Park Dedication $0.00
Issued By: �� � Date 07/29/2013 FinaUO.P. 00/00/0000
❑ Permit Voided' Parcel Id#0702120000
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 h�ave read and u ��o�//��,r�gtion��tion. Date �— —/�
Si nature � t. l�.� �� �
AgenUOwner
Address 890 E LONE ELM AVE OSHKOSH WI 54902 - 0000 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.
POBox 1130
� Cit1 of Oshkosh Oshkosh,WI 54903-1130
� Phone: (920)236-5050
Fax: (920)236-5084
Building Permit Application �•��.OShkosh.w,.Us
Project �.2� n ���
Address /rl"YYl --- --- ----
Applicant Owner Contractor Tenant Other(describe)
Owner! Name �P�C�,: �0�/�C(.wl YY�G��i Ct r� Phone �Z.0 —2.3�—2Q�Z
Tenant �
Address 3 ��'U'�c � � S�IC.Of�. � � Email VYI��a.vrim c.�Sh � c�. ►'tet'
Contractor Company Name c�S p� �red-e_ L-�_ Phone ��—��O—o `C��
Contact �� � ✓� Email
Address � � �J Z �. OCc.kl,�-10Ud �-�J�, �Qe�l� w I ��� ��
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Typ Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project �r� V��f�,�,vl �G�-��( ,GICP VYL2v1�
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job $ I G��� �� (V�ue 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 deviadons from the above submrtted informadon may require addidonal permits
to be obtained. 1 acknowledge and agree to these terms.
Name: �.p�1�.�.� ,��h�{YYL�CG,n (Please print) Date: Z. 3
Signature: