HomeMy WebLinkAbout2013-Building (raze building) � CITY OF OSHKOSH No 158122
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OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 690 W 3RD AVE Create Date 10/07/2013
Project raze building __ Project Number 0
Owner CITY OF OSHKOSH Plan
Contractor CITY OF OSHKOSH
Inspector Nicole Krahn
Designer
Category 285-Raze Structure(s)—Commercial Type of Plan
2oning M-2 _ Square Footage
Major Occ Const Class
Fire Protection � Sprinkled � Unsprinkled � Sprinkler Design
Occupancy Permit _ Flood Plain Height Permit
Park Dedication _ #Dwelling Units 0 #Structures 0
❑ Projection Canopies Signs
Use/Nature
of Work
ICOMM/razing building — --
�
L �
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $0.00 Park Dedication $0.00
Issued By: `� Date 10/07/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id#0603840000
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 authorit easement restrictions of which it is not a party, if you perform the work
described in thi it applicati wi n easeme ,the City strongly urges the permit applicant to contact the easement
holder(s) d to secure any nece ry a v efore starting such activity.
I have r d and unde tand th f e ntione ' ation.
Signature _ Date 7 3
AgenUOwner
Address __ Oshkosh _ WI 54901 - 0000 Telephone Number
* 285-Raze Structure(s)—Commercial 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/pubiications/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 I 130
n l..Z-/-y �f OS���S� Oshkosh,WI 54903-1130
� �' Phone: (920)236-�050
Fax:(920)236-5084
Building Permit Application ����.oshkosh.W�.us
Project C/', J � � v��
Address �L�
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name � ��1��� Phone
Tenant
Address Email
Contractor Company Name Phone
Contact Email
Address
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration �
Project _
Description
.� 2� !r 14�/��
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job $�2� DD� � O �' (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
1 certify the above information is complete and accurate. Any de»iations from the above subnzitted information may requi��e addirional permits :
to be obtained. I acknowledge and agree to these terms. :
Name: (Please print) Date:
Signature: