HomeMy WebLinkAbout0157662-Building � CITY OF OSHKOSH No 157662
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 680 W 5TH AVE Owner EXCEL PROPERTIES LLC Create Date 09/11/2013
Designer Contractor K C BENNET CONSTRUCTION LLC
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy 0 Fence � Raze I
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 0 Floating Slab � Pier � Other
� Concrete Block � Post � Treated Wood --
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dweliing Units 0 #Structures 0
Use/Nature SFR/kitchen remodel to include cabinets,drywall and finish work �
of Work
I"ck#1290'*
—
HVAC Contractor Piumbing Contractor
Electric Contractor
Fees: Valuation $7,000.00 Plan Approval $0.00 Permit Fee Paid $79.00 Park Dedication $0.00
Issued By: � W�.- Date 09/11/2013 Final/O.P. 00/00/0000
v ❑ Permit Voided� Parcel Id#0603360000
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 derstand the afore tioned inform 'on.
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Signature ,,..��1 Date '�r �
!�'�'��c ��, �__
AgenUOwner
Address 3916 LEONARD PT RD Oshkosh WI 54904 - 0000 Telephone Number
* 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 additionai 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 11�0
� �l.l-y �f OS!���5!L Oshkosh,WI 54903-1130
� �' Phone:(920)236-5050
FaY:(920)236-5084
Building Permit Application ��ci.oshkosh.W;.us
Project � ` ...—yf„ �
Address � ��j � ��
Applicant Owner ontractor Tenant Other(describe)
Owner/ Name �` /' Phone Qv(�� >(� � ���
Tenant
Address Email
Contractor Company Name � S(� Phone�� � ��/ `f��3�
Contact �eCj C � Email
Address �P1'J� (�
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State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type esi ential Single Fami Residential Duplex Commercial Multifamily Industrial
Catagory New Addition terati
Project � � t� � � �,
Description
�(�Yl i�S �0 .
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Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job CO U�
$ �(�X�t (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 a6ove information is complete and accurate. Any deviations from the above submitted information may requir•e additional permits
to obtained. I ack owledge and agr e to these terms.
Name: �(���� ��n p � (Please print) Date: �����,,� �
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Signature: ��,(,����'�� :