HomeMy WebLinkAbout0157118-Building (weatherization) /�°i� CITY OF OSHKOSH No 157118
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 232 W 15TH AVE Owner GENEVA J DREYER Create Date 08/08/2013
Designer Contractor ADVOCAP INC
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy 0 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 � 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 ISFR\Weatherization according to attached quote.Any mechanical work will require separate permits
of Work
I :
I
I
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $5,170.22 Plan Approval $0.00 Permit Fee Paid $72.00 Park Dedication $0.00
Issued By: / Date 08/08/2013 Final/O.P. 00/00/0000
❑ Permit Voided I� Parcel Id#0901890000
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 Ciry 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
Agent/Owner
Address PO BOX 1108 FOND DU LAC WI 54936 - 0000 Telephone Number (920)426-0150
* 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.
Ci of Oshkosh � ��
h' �i�spection Services Division �
P 0 Box 1 130
Oshkosh,�54903-1130
Phone:(920)236-5050 O �VO�u
Fax: (920)236-5084 f\ f I
Buiiding Permit Application ON THE WATER
�ou are a contractor articipatinQ in the Permit Fee Account Svstem and have adequate funds. check here
if�ou want this processed throuQh vour account �
JOB ADDRESS l,3 L �.tf /�� (/Q.
RE�'E�VED
OWNER �✓
CONTRACTOR �I�``/��{�/� 1nc, "' � U � 1��3
I am the.: ❑ Owner OR ■ Contractor UEPq;t7'��E1T OF
C0�1�tUtii'i'y DEVcL,OP1fE.VT
USE CATEGORY iVSPE.^'�':' ;En•,;ces�,�•,S,ov
f�inble Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Work being done:
❑Addition ❑Deck/Porch/Patio ❑Driveway/Parking
❑External Remodeling 0 Fence/Hedge/Kennel 0 Garage/CJtility Structure _
❑Handicap Ramp ❑Hot Tub/Spa C Internal Remodeling
❑ SigrvCanopy/Awning ❑Stair/Handrail ��Stove/Fireplace
❑Swimming Pool ❑Wrecking Permit
�Other wea�4�E'r'tzO.�L'1
Additional information, such as pl�n submittal and approval, may be required before issuance. Fliers,
located in the hallway, may be referenced to note if any additional information is necessary.
•:• Full description of work being done: ��� cti-� �-�Cl�ec� w��k �r� �'�
Anv work not included in this application is not permitted.
Value of the j ob $ � ��.G6� _ (Value for materials and labor is requ'ued to ensure consiste�cy in accessing permit fees for all —
applicants.)
PLEASE READ, SIGN, & DATE:
I certify the above information is complete and accurate. Any deviations from the above submitted
information may requir•e additional permits to be obtained. 1 acknotivledge and crgree to these terms.
I�Tame: ____�_n n h7 1-.ar s,��
(Please prmt)
Signature: �1�... n'1 �^^ ��
Date: � --]- t 3
3/02