HomeMy WebLinkAbout0157093-Building (acrylic shower) � CITY OF OSHKOSH No 157093
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 258 W SOUTH PARK AVE Owner GREEN G WAGNER Create Date OS/07/2013
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign 0 Canopy � Fence � Raze I
Zoning R-2 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 0 Floating Slab � Pier � Other
� Concrete Block � Post � Treated Wood
Occupancy Pertnit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/tear out old tub and install acrylic shower
of Work � !
i"`*debit acct" I
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $3,500.00 Plan Approval $0.00 Permit Fee Paid $58.00 Park Dedication $0.00
Issued By: �� Date 08/07/2013 Final/O.P. 00/00/0000
❑ Permit Voided i Parcel Id#0901360000
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. 7. 2013 9: 17AM REBATH CENTRAL WI 9203035935 No. 4426 P, 1/1 .
. '. . . . . , P O Box 1130
� �l� O QS�'C�OS� . . oshkosh,WI 54903-1130 `.
y f •Phone:(920j 236-5050
� . . . Fax:(9?a)�6-5084
. - � . B�u�iding Perxnit �pplicatio�t. ,�"'.G.os�osh."';.�
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�Aaaress F. D � �6t�`h f c-� � �'1 v�. � r 1
Applicant Owner Contractor Tenani Other(describe) �
: Ownei"/ Name t.(:i � � �� Phone /�t/ Z:I�J
� �Tepant'.. :
Address�ytS �1.� :. �,'�'1. � .I�v�-� �d� Email
Contractor p �, - ,. �
Com ari Name �i,( � � Phone �ai� ��� - �� ��
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Contact !.._I L- . . Email �e '11 .!' lY1 :
Address r��O �I, � �Qdl��Y ��`�P.�}T U.��'1�0.�`�'1 �1 �i�n�
State Credential#'s i�aa�55 � , la��'�9/ _, � :
. Dwclling Coati�aor Qualificr# DWClling Conrractor f! IIuilding C:onvactor Regiszration�J
Ac6itect/ Company Name Phone
Desiener
Contact Email
Address �
�ermit Type ResideDtial Single Family R�sidential Duplex Commercial Multifaruily industrial
Catagory New Addition ' Alterarion . �
Project;
� Des¢irrp�on'. ,
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1VIec6anicai Separate permits will be obtained for the followi.rig: . ,, /_ � � .
Pcrmits - ' �
.. . .... ._.__.. _.�El��tucal:�. Plumbin�by L��
� '�p Heating by
:':'!ITa1ue�.of:Job,' $ fi��� ,` DU Naluc for m}v.erials&labor is rnq.io ensure wnsiste � rmit fccs for all applican�s.)
� Payment by: Check # Cash Permit Fee Account :
I certify the above enfOrmallon fs co»iplele ar�d accurale- Any devtations jrom Ihe above st�bmztled informatron�+ay require additio►utl permi[s
1 ob[nr'ned !aUrnowler,�ge and agree to�hese[erms_ .
I�1am : - (PleaSe print) Date_. ::.� .
Signaiw�e: .