HomeMy WebLinkAbout0157287-Building � CITY OF OSHKOSH No 157287
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1131 W 18TH AVE Owner DENNIS L ZARLING Create Date 08/19/2013
Designer Contractor DIMENSIONAL DESIGN LLC
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze �
Zoning R-1 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/interior remodeling to include new cabinets and countertops/removing a non load bearing wall section/two new windows same
of Work size and location as existing/plumbing and electrical will require separate permits/all work will meets state and local codes
I
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $53,000.00 Plan Approval $0.00 Permit Fee Paid $275.50 Park Dedication $0.00
Issued By: ��� Date 08/19/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1310470000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
I have read and understand the afore mentioned information. �
Signature ��_�,.1/— Date 7j'��7��✓�
Agent/Owner
Address W5230 PLEASANT RD BLACKCREEK WI 54106 - 0000 Telephone Number
* 140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500-113 on the DNR
Asbestos Program website;http://dnr.wi.gov/air/compenf/asbestos/.For additional information on hazards present in buildings see
the Pre-Demolition Environmental Checklist at http://dnr.wi.gov/org/aw/wm/publications/anewpub/WA651.pdf
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
P O Box 1130
� l�lty �f OS!L�OS!L Oshkosh,WI 54903-1130
� Phone: (920)236-5050
Fax: (920)236-5084
Building Permit Application �W���.oshkosh.wi.us
Project I I� � �� �gT�' S�.
Address
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name�EE1�Y � �I�NIS �i4Qll�(� Phone �'j0- Z3�'y��
Tenant
Address � (3� Ir�� ��� .� Email
Contractor Company Name �)��l)$'IOI�A(. 6�16l� LLL Phone qzQ-��-�Zj 7 :
Contact____��'�" ��� Email
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State Gedential#'s j �� Z�� , '�3 yZ0�1 ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Typ Residential Sin le il Residential Duplex Commercial Multifamily lndustrial
Catagory New Addition teration
Project
Description
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Mechanical Separate permits will be obtained for the following:
Permits Electrical b ���/�.�� �(F�. Plumbin b ,f� g by
y g y �_�y�.;�, Heatin
Value of Job
$ S � (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: heck #�� Cash Permit Fee Account
I certify the above information is complete and accurate. Any deviations from the above submitted information may requir�e additiona/permits
to be obtained. I acknowledge and agree to these terms.
Name: �Jr T)' �/�„����(Please print) Date: ��//'��
Signature: �