HomeMy WebLinkAbout0158087-Building (porch) � CITY OF OSHKOSH No 158087
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1917 MICHIGAN ST __ Owner KOEPP LIVING TRUST Create Date 09/30/2013
Designer Contractor OWNER
Inspector Nicole Krahn
Category * 140-Interior Remodeling _ _ Plan
Type � Building � Sign � Canopy 0 Fence � Raze i
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 0 Floating Slab � Pier � Other ;
� Concrete Block � Post 0 Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature ,SFR\Finishing porch interoir.All work to meet current code requirements.
of Work
I
HVAC Contractor Piumbing Contractor
Electric Contractor
Fees: Valuation 75.00 Pian Approval $0.00 Permit Fee Paid $37.00 Park Dedication $0.00
Issued By: '—� Date 10/03/2013 Final/O.P. 00l00/0000
❑ Permit Voided, Parcel Id# 1409580000
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.
*140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administretive 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
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 aforementioned information.
Signature Date
Agent/Owner
Address 311 WEST LAKE DR RANDOM LAKE WI 53075 - 1767 Telephone Number
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
Cit�of Osh�osh Oshkosh,WI 54903-1 1 30
� Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application ����.oshkosh.,�.�s
aaa�ts � � � Gin l Q �l �'. Ko sV� D �
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name `�0 ep P ��v i nc� Ti-u.sf �Ou7Gtl h E a-�ctn i���hone 9��-���� ���
T+w�
311 w. 1�.(c 3o�s
Address e, �`. Email p v> � ` � n-�
Coutractor Company Name ��/�.p � Phone
Contact Email
Address
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Conlractor# 'stration#
Achitect/ Company Name f�f p I'1� Phone
Designer :
Contact Err►ail OCT 0 3 2013
Addl'8SS D£PARTA1E'.iT OF
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project �'!y� i s� � ►� q Cz, ro�.�.q l��d -i h r'ODY� , ;
Description
�t,��' {��u c:��ooc� o n �l oo r - Pu,�{"t�t 4 �o r u t,�?a-� �
Mechaaical Separate permits will be obtained for the following:
Permits Electrical by bt�i'�Z(<,� ���, • Plumbing by — Heating by —
Value of Job $ � �?� Oo
�, � (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account po :
. �
I cert�the above information is complete and accurate. Any deviatiorrs from the above submitted information moy require additional permits
to be obtoined. /acknowledge and agree to these terms.
Name: �o Ql t'l e, (Please print) Date: � p— � — � �
Signature: ,