HomeMy WebLinkAbout0157973-Building � CITY OF OSHKOSH No 157973
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 845 HERITAGE TRL Owner KERRY D HUBERTY Create Date 09/27/2013
Designer Contractor OWNER
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze I
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
� 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/interior remodel to include new drywall,cabinets,countertops/all work will meet state and local codes/electric and plumbing �
of Work �require separate permits/no walls being moved or added/no windows being replaced
-- --
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $3,500.00 Plan Approval $0.00 Permit Fee Paid $58.00 Park Dedication $0.00
Issued By: _�� Date 09/27/2013 Final/O.P. 00/00/0000
❑ Perrnit Voided I� Parcel Id#0613980000
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 a roval before starting such activity.
I have read and u ef�d sta the afore enti d information.
Signature Date ��
Agen ner
Address Oshkosh WI 54901 - 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 additional 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.
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❑ Check this box if you are a contractor participating in the Permit Fee Account System and you would
like this permit prccessed thre�.��h o!ir a�co�_�nt. �
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Project Address: � '��� �� /,�ircle one: ingle Family Duplex
Owner's Name: �' - � �-�-y` Da time Phone#: lp/Z ������!
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Contractor's Name: ��,,�a �.u�?/" Daytime Phone#:
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If the contractor is applying for the permit provide the following:
Dwelling Contractor# �� Contractor QualiCiet� # O�%�
*These two credentials are requirect y the State of Wisconsin.Scrfetv and&tildings Division for any contractors
conducting work on residential property.
Value of the project including labor and material costs $ .� ��
*7Tie value for both materials and labor is required to ensure consiste�cy in asse.ssing per�rrit fees for all applicants
even if you're doing your own work. A general rule of tl�umb is to double the material cost oi•prol�de an esd�nate �
from a contractor.
Full description of the work being done:
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Electrical Work is being done by: , u/
Plumbing Work is being done by: , / /
Heating Work is being done by:
Any work not noted on this application will not be included on the permit!
The following documents are attached to this application:
c� 2 Sets of Frarning Plans ❑ Appliea.ble fees
Please read the following and sign and date this application prior to applying for the building permit.
I certi fy the above in formation is complete and accurate. Any deviations fi�om the above submitted
information may reguire additional reinews arrd permits to be obtained. I acknowledge and agree to these
terms.
Signature: Date:������
4 1/4/2013
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