HomeMy WebLinkAbout0158095-Building (driveway) � CITY OF OSHKOSH No 158095
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER .
Job Address 1250 S WESTHAVEN DR Owner THOMAS UMARY COOK REV TRUST Create Date 10/03/2013
Designer Contractor JACK CLEVEN INC
Inspector Nicole Krahn
Category 256-Residential Driveway Plan
Type � Building 0 Sign � Canopy � Fence � Raze !
2oning 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 � Floating Slab � Pier 0 Other
� Concrete Block � Post 0 Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit Not Required
Park Dedication Not Required #Dweliing Units 0 #Structures 0
Use/Nature SFR(LATE PERMIT)/REPLACING DRIVEWAYAS APPROVED BY THE ZONING DEPARTMENT
of Work
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_ —
HVAC Contractor Plumbing Contractor
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—
—
Electric Contractor
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $175.00 Park Dedication $0.00
Issued By:���I� Date 10/03/2013 Final/O.P. 00/00/0000
❑ Permit Voided ' Parcel Id# 1312280000
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 understa af tio�rmation.
Signature Date �U��'"�-�
Agent/Owner
Address 2451 PATRIOT LN Oshkosh WI 54904 - 6924 Telephone Number 920-731-7416
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 .
� City of O,SlL��.S� Oshkosh,WI 54903-1 Li0
� Phone: (920)236-5050
Fa�c:(920)236-5084
Building Permit Application �W���.oshkosh.W,.�s
Project 1 \
Address ��S� �e 4�/Q_ �c , 0�(���5 h
Applicant Contractor Tenant Other(describe)
Tnant/ Name I o �..� ��� Phone��9�b1 �.� �j "6`���
Address � a,�b � eS� �^4v Q.n �< � Email
Contractor Com an Name G�� �--1��/¢. �' �q aD� ? '�� -7`-�� (p
P Y �0 I� Lf�G � Phone
Contact ,'����1 C,,12ven Email
Address �.L�S� �6�'i �� 1— � ��oS�,
State Credential#'s , , I�s�g�g
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Ty Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project `���\a�e �1�; vev�►q� �Px��s��no�
Description
Mechanical Separate permits will be obtained for the following: :
Permits Electrical by Plumbing by Heating by
Value of Job �
$ p�,b�(� (Value for materials&labor is sure wnsistenc}�in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I certify the above information is complete and accurate. Any deviations fro�n the above submitted informarion mav reguir�e addilional permits
to be obtained. I acknowledge and agree to these terms.
Name: �ic<,9t'� C,�vr�n (Pleasepr;nt) Date: /� - .;' -/.3
Signature: ���%�'�/������