HomeMy WebLinkAbout2013-Building (raze structure) � CITY OF OSHKOSH No 157621
OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 680 W 3RD AVE Create Date 09l09/2013
Project Raze building.
- Project Number 0
Owner DRH LLC Plan
Contractor CITY OF OSHKOSH
Inspector John Zarate
Designer
Category 285-Raze Structure(s)—Commercial Type of Plan
Zoning M-2 Square Footage
Major Occ Const Class
Fire Protection � Sprinkled � Unsprinkled
� Sprinkler Design
Occupancy Permit Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
❑ Projection ', Canopies Signs
Use/Nature
of Work
COMM/Raze commercial structure associated with central garage pro�ect.
:
HVAC Contractor Plumbing Contractor
Electric Contrector
Fees: Valuation $1,000.00 Plan Approval $0.00 Permit Fee Paid $0.00 Park Dedication $0.00
Issued By: Date 09/09/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id#0603810000
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 er d the afor e ed information.
Signature Date ��'2��
AgenUOwner
Address Oshkosh WI 54901 - 0000 Telephone Number
�`Raze 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 Box1130
City of OS/�/C�.SIG Oshkosh,WI 54903-ll30
� Phone:(920)236-5050
F�:(920)236-5084
Building Permit Application ����.oshkosh.w;.�s
rro�e�c /�O
Address (� ��� �
Applicant wner Contractor Tenant Other(describe)
Owner/ Name G.i�-k/ mT �� Phone �a� "��—S"�O :
Tenant �
Address Email
Contractor Company Name_G,'�y D� �i�� Phone
Contact Email
Address
State Credential #'s
,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name_�ri�J o-���� w Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial :
Catagory New Addition Alteration
Project
Description
� C.y`/�-✓` �r'C� ..2 .
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbin b
g y � Heating by
Value of Job
$ (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I certify the above informarion is complete and accw�ate. Any deniations from the above subnaitted information may requi�•e odditional permits
to be obtained. I acknowledge and agree to these terms.
N3me: (Please print) Date:
Signature: