HomeMy WebLinkAbout0157628-Building (parking lot) �
�
� CITY OF OSHKOSH
No 157628 �
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 138 ALGOMA BLVD Owner STAPEL PROPERTIES LLC Create Date 09/09/2013
Designer Contractor OWNER
Inspector John Zarate
Category 257-Commercial Parking Lot/Driveway Plan
Type � Building � Sign 0 Canopy � Fence � Raze_ I
Zoning C-3D0 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 Not Required Occupancy Fee $0.00 Flood Plain Height Permit Not Required
Park Dedication Not Required #Dwelling Units 0 #Structures 0
Use/Nature 'COM/Remove and replace 780 sf of existing concrete parking lot and remove 800 sf of existing gravel to be replaced with concrete.
of Work "check#7898
I �
HVAC Contractor Piumbing Contractor
Electric Contractor
Fees: Valuation $6,850.00 Plan Approval $0.00 Permit Fee Paid $279.00 Park Dedication $0.00
issued By: ��� Date 09/10/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id#0701220000
Cautionarv Statement to Owners Obtaininq Buildinq Permits
101.65(1 r)of the Wisconsin Statutes requires municipalities that enforce the Uniform Dwelling Code to provide an owner who applies for a
building permit with a statement advising the owner that:
If the owner hires a contractor to perForm work under the building permit and the contractor is not bonded or insured as required under
s. 101.654(2)(a),the following consequences might occur:
(a)The Owner may be held liable for any bodily injury to or death of others or for any damage to the property of others that arises out of
the work performed under the building permit or that is caused by any negligence by the contractor that occurs in connection with the
work performed under the building permit.
(b)The Owner may not be able to collect from the contractor damages for any loss sustained by the owner because of a violation by the
contractor of the one and two family dwelling code or an ordinance enacted under sub.(1)(a),because of any bodily injury to or
death of others or damage to the property of others that arise out of the work performed under the building permit or because of any
bodily injury to or death of others of damage to the property of others that is caused by any negligence by the contractor that occurs
in connection with the work performed under the building permit.
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 secur ny necessary a rovals before starting such activity.
I have read and und tand the tione ' ormation.
Signature Date � `3
AgenUOwner ,
Address 427 MAIN ST OSHKOSH WI 54901 - 4900 Telephone Number
To schedul nspections 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.
.ZA�
� P O Box 1130 ;
� CitJ of Os�kosb S Oshkosh,WI 54903-1130 �
� Phone:(920)236-5050
Fax:(920)236-5084 :
�
Building Permit Application ��ci.oshkosh.W;.us ;
��
f
Project 9
Address I� g �� b�N�..
�
Applicant wner Contractor Tenant Other(describe)
Owner/ Name ^ }
Tenant
.S � ti'l .S ���� Phone ��p �.l 3 f'd
Address ��, , Email �.r UfiP.
Contractor Company Name / V�wt, `�'C �� 1�� Phone y �w � $ `fl� �� i
;
Contact �l �,� /I�� f � Email N " ;
Address .S �� �, �,�/� ' }
� �
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial `<
;
Catagory New Addition Alteration
i
Project ' � _�
Description .� �
�
f.+` /
��
�
�
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
#
Value of Job
$ ✓�ue for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
1 certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be obtained. I acknowledg and agree to these terms.
Name: � (Please print) Date:
Signature:
�