HomeMy WebLinkAbout0157972-Building (driveway & garage slab) � CITY OF OSHKOSH No 157972
�
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1123 KANSAS ST Owner AMY R LEGRAND Create Date 09/23/2013
Designer Contractor AFFORDABLE CONCRETE LLC
Inspector Nicole Krahn
Category 256-Residential Driveway Plan
Type � Building � Sign 0 Canopy 0 Fence � Raze I
Zoning R-2 Class of Const: Size
Unfnished/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 0 Pier � Other
� Concrete Block � Post � Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication _ #Dwelling Units 0 #Structures 0
Use/Nature SFR/Installing a new concrete driveway and garage slab
of Work
�
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Vaivation $3,000.00 Plan Approval $0.00 Permit Fee Paid $107.00 Park Dedication $0.00
Issued By: 1� Date 09/27/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1308410000
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 understan the afore mentioned'nformation. ' '
Signature, � Date °� o�-� �
AgenUOwner
Address 225 W HURON AVE OMRO WI 54963 - 0000 Telephone Number 379-4709
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 1130
Clty �f OS!L��s� Oshkosh,WI 54903-1130
� Phone:(920)236-5050
Fax: (920)236-5084
Building Permit Application ��ci.oshkosh.wi.us ;
Project j I_�� 1<C�,►15c�S �4- OSI�k0�� U� 5�(-�o a
Address ,�
Applicant wne Contractor , Tenant Other(describe)
Owner/ ��- G
Name�(Yll/� �,Q_,�1�� - ___ Phone ��-,�O-t-�-Iv '+���j
Tenant -
Address (��; �j �Q.�'� rS-�. • �Y�� �(�,�Email � Q � ,�"'I�� �
Contractor CompanyName�(,U.I.�,Q, ���'1(.f� �P Phone �0�'37�-�O��d
Contact Email
Address
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
chitect/ ' Company Name Phone
ig
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project �' ��v.�� � ����+��
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job
$ � (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 above information is conaplete and occurate. Any a'eviations from the above submitted information may requii•e odditional permits
to be obtained. I acknowledge and y�ree to these terms.
ibl
Nan1e:,�'�,(/� �Q�r�I1�J�- (Please print) Date:
�
Signature: L