HomeMy WebLinkAbout0158154-Building (windows) � CITY OF OSHKOSH No �5s�sa
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 910 ALPINE CT Owner KATHY L HEINEN Create Date 10/08/2013
Designer Contractor OWNER
Inspector John Zarate
Category 040-Windows Plan
Type � Building � Sign 0 Canopy � Fence � Raze �,
Zoning R-1 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
0 Concrete Block � Post � Treated Wood -
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR\Lowes-replacement windows throughout
of Work
I
I
II --- ---- -- �
HVAC Contractor _ Plumbing Contractor
Electric Contractor
Fees: Valuation $10,000.00 Plan Approval $0.00 Permit Fee Paid $100.00 Park Dedication $0.00
Issued By: ��� Date 10/08/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 1525200000
Cautionarv Statement to Owners Obtaininq Buildinq Permits
101.65(1 r)of the Wisconsin Statutes requires municipalities that enforce the Uniform Dwelling Code to provide an owner who applies for a
building permit with a statement advising the owner that:
If the owner hires a contractor to perform work under the building permit and the contractor is not bonded or insured as required under
s. 101.654(2)(a),the following consequences might occur.
(a)The Owner may be held liable for any bodily injury to or death of others or for any damage to the property of others that arises out of
the work performed under the building permit or that is caused by any negligence by the contractor that occurs in connection with the
work performed under the building permit.
(b)The Owner may not be able to collect from the contractor damages for any loss sustained by the owner because of a violation by the
contractor of the one and two family dwelling code or an ordinance enacted under sub.(1)(a), because of any bodily injury to or
death of others or damage to the property of others that arise out of the work performed under the building permit or because of any
bodily injury to or death of others of damage to the property of others that is caused by any negligence by the contractor that occurs
in connection with the work performed under the building permit.
In the performance of this work I agree to perform all wo ursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enfo e,�asement restrictions of which it is not a party, if you perform the work ,
described in this permit plication within a as ment,the City strongly urges the permit applicant to contact the easement
holder(s)and to secu any ne ry app ov s before starting such activity.
I have read a ers nd t e af em n on i formation.� / r,� �
Signat e Date U ��
� AgenUOwner
Address 910 ALPINE OSHKOSH WI 54901 - 2008 Telephone Number
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
n �lLy �f 0����SIL Oshkosh,WI54903-1]30
� Phone:(920)236-5050
Fa�c: (920)236-5084
Building Permit Application ��ci.oshkosh.wi.us
Project �/ D � � ���� � �� /
Address
Applicant Owne Contractor Tenant Other(describe)
Owner/ Name � Phone �� �P ` l�Z �
Tenant �
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Address % � � Email ��" ���U� �" e
Contractor Company Name 'U'� 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
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Proj ect �%�� �'
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job ��, 0� (� .
$ (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account ,
I certi the ab �e infornlation is co�plete and accurate. Any deviations from the above subnaitted information may require additional pe�•mits
to be btai d. I c owledg and agree to these terms. � /�� � /
/� � lJ � �
N me: n C/G'� (Please print) Date:
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Signature: ' ���i