HomeMy WebLinkAbout157119 Building (new entry door) � CITY OF OSHKOSH No 157119
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1030 ARDMORE TRL Owner ROBERT B CRANDALL Create Date 08/08/2013
Designer Contractor FFD NATIONAL LLC
Inspector John Zarate
Category * 140-Interior Remodeling ___ __ _ Plan
Type � Building � Sign � Canopy � Fence � Raze �
Zoning R-1 _ Class of Const: Size
UnfinishedlBasement _ Sq.Ft. Rooms Height ___ Ft. ❑ Projection J
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
UselNature SFR/install new entry door
of Work
"ck#113890'*
-- — ----------------------------------'
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $1,900.00 Plan Approval $0.00 Permit Fee Paid $44.00 Park Dedication $0.00
Issued By: ��/y� Date 08/08/2013 FinaUO.P. 00/00/0000
❑ Permit Voided' Parcel Id# 1314010000
In the performance of this work I agree to pertorm 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 1125 TUCKAWAY LN STE C MENASHA WI 54952 - 1776 Telephone Number (920)968-1480
* 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.
� P O Box 1 130
City of O.SI L��.SI L Oshkosh,Wt �4903-1 L.iO
� Phone: (920)236-�0�0
Fas:(920)236-�084
Building Permit Application ��'�'•ci.oshkosh.wi.us
Project � �� � / / r, ,�Gr/
Address /�� /T/�/�?G � %/�j�i �� Qsh,�co h�� ��l'/�I
Applicant Owner'� Contractor Tenant Other(describe)
Owner/ Name ���'}'L (...���.�� Phone /� �(O ��J?O
Tenant
Address �(J�0 �'�i�/1�Ok'G %/i',ry l Email
Contractor Com an Name l�f--a /��ll Z!J 9�� /��
p y Phone �
Contact��,�C' 1����j'�' Email/���'i'�-�fi7'T�' ����_ �M-
Address //� YV ' L�i�A�w � t� AS/� �4 W �' S T�J �
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State Credential #'s ��7�D.,��2-- , j(��v T�Co ,
Dwelling Contractor Qualifier# Dwellin�Contractor# Building Contractor Registration#
Achitect/ Co:mpany Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family '�� Resid ntial Duplex Commercial Multifamily Industrial
Catagory New Addition eration� ,,�,/
Project ��N��!�' � Cf�-�;YL`ii � .i�aBC I� ��l Si lr�-� (Y�`��n '
Description — �—
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AUG 0 8 2013
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Mechanical Separate permits will be obtained for the followin�:
Permits �?Lectrical by_ Plumbing by Heating by
Value of Job C� "`'
� ( I�U° (Vzlue for materials&labor is req.to ensure consistency in accessing permit fees for all appliclnts.)
Payment by: hec I/�v�l a Cash Permit Fee Account
1 certify the above infor��sation is complete and accurale. Any devia�ions fi•om the nbove subniitted infa•matiom m�v require additional pei•mits
to be obt lned. 1 acknowled�e a�ad a�ree to these te��s.
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Name: � l� � �� i�/�}'� (Please print) Date: �/�.t'//�3
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Si�nature: �p��� � /�}}%�