HomeMy WebLinkAbout0157274-Building (install shower) � CITY OF OSHKOSH No �s�2�a
OSHKOSH BUILDING PERMIT -APPUCATION AND RECORD
ON THE WATER
Job Address 1349 LIBERTY ST Owner MARY C HIELSBERG 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
Zoning R-2 Class of Const:
Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. � Projection j
Finished/Living Sq.Ft. Bedrooms Stories _ Canopies
Garege 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 #Dweliing Units 0 #Structures 0
Use/Nature SFR/remove old tub and install shower
of Work
debit acct"
I
I
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $4,126.00 Plan Approval $0.00 Permit Fee Paid $65.00 Park Dedication $0.00
Issued By: ,�
Date 08/19/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1206220000
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 othervvise,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.
Rug � l "1U13 1"1: 1"1NM REBATH CENTRAL WI 9203035935 : � . No. 4462 P. 1/3
� ' ' ' P O Box 1130
' � . C�t Q �S " Oshkosh,WI 54903-1130
� � ��OS� . . . • Phone:(920)236-5050
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• Fax:(9?0)236-5084.
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Achitect/ Comp y Name
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Mec�anical $epar�tte permits will be oUtained for the following:
Permits `
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. . _.�l��h:i��l.liy: _.. Plutnbing by��j(.�O)')'7 S Heati.ng by
Va1ne,:of:Joli�. S � �(Q � a .
(Value fur��E�rial�&c labor is ieq,to cnsure consiste rmit fccs for all appti�,)
Payment by: � . Chec�C �! Cash Per�mir Fee Accounc
I cer�jy the above l,rfornration.is complete ond acc►oate: qrry dev;qtions fiom�abovc submined information nmy requi�e additionnlpe►•»r:�r
!o be ined. I acbrowledge agree.lo fhese lerrrrs: .
Nanne: �'. .� � .
(Pltasc Priat) Date• � �'.
Signature: ' �