HomeMy WebLinkAbout0157658-Building (new acrylic shower base) � CITY OF OSHKOSH No 157658
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 221 LAKE POINTE DR Owner GLADYS C RIETZ Create Date 09/11/2013
Designer Contractor REBATH OF CENTRAL WISCONSIN
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze
Zoning C-1 PD Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms ___ Height Ft. ❑ Projection I
Finished/Living Sq.Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths _ _ Signs
Foundation � Poured Concrete � Floating Slab � Pier � Other
� Concrete Block 0 Post � Treated Wood _
Occupancy Permit __ Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/remove and dispose of old shower,install new acrylic shower base and necessary drywall repairs
of Work ' ,
�I**debit acct** I
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $4,800.00 Plan Approval $0.00 Permit Fee Paid $65.00 Park Dedication $0.00
Issued By: 71N� Date 09/11/2013 Final/O.P. 00/00/0000
❑ Permit Voided'� Parcel Id#0614407514
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 understand the afore mentioned information.
Signature Date
AgenUOwner
Address 230 N KOELLER ST OSHKOSH WI 54902 -4109 Telephone Number (920)303-5797
* 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.
Sep 11 2013 11 : 05AM � REBATH CENTRAL WI 9203035935 . No. 4529 P, 1/4
� � � � � � ��P O�ox 1130
� ' � Oshlcosh,WI.54903-1130 .
� Clt O .OSI�'L�OS�'L .
• . � �., • • . • . . � . Phone_(920)236-5050
� , . . : Fax:(920 23G-5084
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� . - � Build�ng Permi# App�cation . _ ..�.�LOSbka�h,w;.�s :
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� iPr:oject": � .
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- Applicant Owner _ �Contractor Tenar►t Other(describe) �
` �w�a�er;�` Name ,� . ' Phone rP►J�
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. Addres3�1 LGI.� �611�1�. V[ . Emaii
' Contractor .� Company Name�I,U � ��/1(',/1-1Q� `�,1,d I U�(�� Phone - � �
Conta.ct .,. Email � �. ��T� � ,�' /9'1
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State Credential#�S_G�a�� :1a���9� ; :
Dwelling Conun��t��r QvaLificr# Dwelling Coimaaor i! Building Conuactor Registration#
Achxtect/ Company Nar,�e � Phone �
Desianer {��] -�y .
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Contact Exnail
Address . . � .
Permit Ty.�e.. Residenjial Single Family �,� Residential Duplex Corr►mercial Multifamily Tn�dustrial
Catagory New Addition %� Alteration, . . �
Project:•:� .
�.D�escr�ip.tio�`.
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. li7(echanical Separate peimits wil( be obtai.ned for the foilowing. �.
Pertnifs .:��tric���X : . � �;Plumbin
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_ _�TS.Iu�of Job. $��/� � � (V��for makrials 8c lsbor is neq.to easure consiste . rma tees for atI applicants)
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� Payment by:. � � :Check # Cash Permit Fee Account
� I cenrfythe above irrfor�uu;on is compleie nnd accro�ate: Arry deviations from 1he abnve sr�bnrirted info►mation»�ay require addirional permi[s
� to ined !acknowl ge Q►ul agree to lhese[ernis
N'ame: �. . . �
(Plcase pr;nt). . Aa[e: �. I I � I�
. Signature: . : : .
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