HomeMy WebLinkAbout0157275-Building (install shower) � CITY OF OSHKOSH No 157275
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2600 HAVENWOOD DR Owner THE HOMES OF HAVENWOOD VILLAGE IV Create Date 08/19/2013
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze I
Zoning Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection I
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 #Dweiling Units 0 #Structures 0
Use/Nature ISFR/remove old tub and install shower
of Work
;'�debit acct"
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HVAC Contractor _ Plumbing Contractor
Electric Contractor
Fees: Valuation $5,151.00 Plan Approval $0.00 Permit Fee Paid $72.00 Park Dedication $0.00
issued By: �/�/1/l Date 08/19/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel id#
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 1 /, 1U13 12. 12PM REBATH CENTRAL WI 9203035935 No 4462 P. 2/3
, P O Box 1130
� CZ� Of, OS/L�OS� , � ; Oshkosh,WI54903-1130
� J Phone:(920)236-3050
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DwoUa�g Contiacror QualiL`er il Dwelling CunLrauor# �uilding Coutracto�Rc��*Mlfion#
Achitect/ C �p �e y� . Phone
Designer �b��
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Address �
Permit�ype Residential Single Fa,mily Residential Duplcx Commercial Mtiltifamily lndustrial
Catagoty New Addition � Alteration
Pro,ject ;�. . .
. Desciiption�; . �
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Mechanical� Separate permits will be obtainul for the following:
Permits ..;` ::. ..
......... _:�_Electrical`'b..: .�'._ ... . � �---.-..
y �plumbing by°��l�S I�eatzng by
�Value�oi Job? � t �-`r . ..
� $s_ZL�� • V(J (Value for ma[erials&labor is req.tc►enyure consist �emiu Fees for all applicsn�e.)
Payment by: Check #t Cash Permit Fee Account
'!cerlify Ihe above irr�'orn�orlon is cornpleie and accurare. dny devinlions from the a6ove submilred�zformalion may require addiqonal permi[s
�o ba ob ' ed !acblow e cmd agree�o these tenns. .
Name: Gt.Ll 11 . -�-5 ki b (Please�p��t) ' . Da�e: j 3
Sigtaature: