HomeMy WebLinkAbout0158018-Building /�"� CITY OF OSHKOSH No 158018
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1410 INDIGO DR Owner ELLEN M VANDERMOLED Create Date 10/01/2013
Designer Contractor FLOOD MOBILE HOMES, INC
Inspector Nicole Krahn
Category 134-New Mobile Home Plan .
Type � Building � Sign � Canopy � Fence � Raze I
Zoning Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection ;
Finished/Living 1216 Sq.Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation � Poured Concrete 0 Floating Slab � Pier � Other
� Concrete Block � Post � Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature New Mobile Home/Install 16'x 76'concrete slab with 16'x 76'new mobile home per approved site plan. Stair locations will be reused
of Work from prior home. �II
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HVAC Contrector Plumbing Contractor
Electric Contractor
Fees: Valuation $5 Plan Approval $0.00 Permit Fee Paid $243.88 Park Dedication $0.00
Issued By: Date 10/01/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcei Id# 1307310100
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 und rst d the afore mentioned information.
Signature Date Q - � �
AgenUOwner
Address N7559 N PIONEER RD FOND DU LAC WI 54937 - 9714 Telephone Number 922-2222
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
C.L�y �f OS G�OS� Oshkosh,WI 54903-1130
� �L Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application N'µ'�'•ci.oshkosh.wi.us
Project
Address � ��v �NI/7�0 ('/(� Vt Usl►'C°s� U-�� ��f y�2-
Applicant Owner Contractor Tenant Other(describe)
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Tenant
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Contact �C'� /�'I�r�/�2 C Email � S� ,�d vd �
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State Gedential #'s 9� �� � � , �� (0 8/ Z .
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Emai I
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project ��D//��/�� /y1 a�✓���[. /�6Yh.L l�+r�� .f�NrGJ ��'llr
Description
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Mechanical Separate permits will be obtained for the following:
Permits Electrical by j�.4 ��irvfr ,��4� Plumbingby �j�����L'3°� •Heatingby
Value of Job $ s' U� Z uu�
�Q. (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 informntion is comple[e and accurate. Any deviations from the nbove subn:itted information may require additional per»fits
to be obtained. I acknowledge and agree to these terrr:s.
Name: .�r' �'l 'Q C A S (Please print) Date: CJ ,j� ' ��
Signature: