HomeMy WebLinkAbout0157988-Building (driveway) � CITY OF OSHKOSH No 157988
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 811 W 10TH AVE Owner RICKEY UDEBRA S GEMPELER Create Date 09l30/2013
Designer Contractor SCOTT EHNERT
Inspector Jerry Fabisch
Category 256-Residential Driveway Plan
Type � Building � Sign � Canopy � Fence � Raze �
Zoning R-2 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
0 Concrete Block � Post � Treated Wood
Occupancy Permit Occupancy Fee $0.00 Fiood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/Replace existing driveway with new concrete driveway. '
of Work I
I
I I�
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $4,300.00 Pian Approval $0.00 Permit Fee Paid $196.00 Park Dedication $0.00
Issued By: r,f� Date 09/30/2013 Final/O.P. 00/00/0000
❑ Permit Voided j Parcel Id# 1306130100
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 appro befo starting such activity.
I have read and rstand the afo men' inf ation.
�
Signature Date�— � U' �
AgenUOwner
Address 944 OSBORN AVE OSHKOSH WI 54902 - 6358 Telephone Number (920)216-1395
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
� �l�y Of OS���SlL Oshkosh,WI54903-1130
� Phone:(920)236-5050
Fax: (920)236-5084
Building Permit Application W�•ci.oshkosh.wi.us
Project C� ( � � � � � �� /% � � �a�/
Address v �
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name_�L1���l�/��-- Phone
Tenant
Address Email
Contractor Company Name (� �T '— Phone ( `'7 �j'
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Contact Email ��
Address � `'( `� (���� ��i,�,� '
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State Credential#'s , , �
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name�c.� '�'T! �:� L v�.�:� Phone � ''–'e
Designer :
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project
Description
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Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job �-U
$ L( �jOd_ (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 informatBon is co�nplete and accurate. Any deviations from the above submitted information may require additiona!pe��mits
ao be obtained. 1 acknowledge and agree to these terms.
N2me: (Please print) D1te:
Signature: