HomeMy WebLinkAbout2013-Building � CITY OF OSHKOSH No 15soa4
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 256 WYLDEWOOD DR#B Owner GARY ULINDA L PEPPLER __ Create Date 10/OU2013
Designer Contractor VANDENBOOGAARD CONSTRUCTION
Inspector John Zarate
. Category * 140-Interior Remodeling Plan
Type � Building � Sign 0 Canopy � Fence _ � Raze J
Zoning R-3PD Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection
Finished/Living 665 Sq.Ft. Bedrooms __ Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation � Poured Concrete � Floating Slab 0 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 COMM/ Condo unit. Basement remodel. Adding a family room,game room and bathroom per floor plan. All construction shall comply ,
of Wo�k ith State and local codes. I
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HVAC Contractor __ Plumbing Contractor R AND R PLUMBING, LLC
Electric Contractor SECKAR ELECTRIC CO INC
Fees: Valuation $13,00 lan Approval $25.00 Permit Fee Paid $119.70 Park Dedication $0.00
Issued By: _� Date 10/02/2013 Final/O.P. 00/00/0000
❑ PermitVoided Parceild# 1632000700
In the performance of this work 1 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 app ovals before starting such activity.
I have read a u d he afore menti ed information.
Signature '1�o A_ � Date ��"��
Agent/Owner
Address 918 EVANS ST _ Oshkosh WI 54901 - 0000 Telephone Number 426-5821
* 140-Interior Remodeling 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 Box 1 Li0
� �'lt-y �f OS!��OS!� Oshkosh,WI 54903-1130
� Phone: (920)236-5050
Fax: (920)236-5084
Building Permit Application Www���.oshkosh.W;.us
Project ��� W'- I���UUO�
Address
Appiicant Owner ontract Tenant Other(describe)
Owner/ Name � t� � Phone �(d - ��-(3�
Tenant
Address 6 � i_�c�c� Email
Contractor Company Name������dg��(� �Q���., u C Phone I�C�—�(����c1 j
Contact -��� T� Email 3��L ����
Address � � 2� �c��.�S S� •
State Gedential #'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Cont�-actor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type ��sidential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory - New Addition lteration
Project m �.`� S �,
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by 5���+(� Plumbin b
g y__�.°' Heating by
Value of Job /
$__[���n,('�� (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # S 5��� Cash Permit Fee Account
1 certify the above information is complete and accu��ate. Arry deviations from the above subnaitted information may require odditional pennits
t be obtaine I knowledge�agree to these terms.
Name: ���' �_ , �c1 �2� (Please print) Date: �C�^ � " � �
Signature: � �