HomeMy WebLinkAbout2013-Building (windows) � CITY OF OSHKOSH No �5s23o
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OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 39 W 12TH AVE Owner WAYNE W SOBIESCZYK Create Date 10/14/2013
Designer Contractor WINDOW WORLD OF MILWAUKEE
Inspector John Zarate
Category 040-Windows Plan
Type � Building 0 Sign � Canopy � Fence � Raze '
Zoning R-2 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 � Floating Slab � Pier � Other
0 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/install(16)replacement windows in existing openings �
of Work
I**debit acct*' I
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $5,490.00 Plan Approval $0.00 Permit Fee Paid $72.00 Park Dedication $0.00
Issued By: �I/�' Date 10/14/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id#0303540000
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 W188 N10707 MAPLE RD GERMANTOWN WI 53022 - 0000 Telephone Number 920-923-4189
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.
10-14-'13 09;56 F�OM- T-401 P0004/0009 F-721
� P 0 Box 1130
� �it 0 �S�'t�OS� � o�o8n,wr s4so3a i3o
y f Phone:(920)236•5030
� Fax;(920)236-5084
Buildi�ng Perm�t Application �•c�oshkosh.�.�s
Project �
Address� � w la��h s}. (��h �!o�h h► ��c� p�
App6cant Owner Contracto Tenant Other(describe)
Owner/ Name��ul i'��' �����I e.S�CZ41 � Phone �i���1(9' b�+7 C
Tenant
Address�� W. 1�-4-1�_ .�1-. C�Sh�(�Sh l�y 1 �q� �� ,
Contrector Company�Name���1(�1�►y��� Qf��r�(l �e�C._Phone Z�OZ��:�-��
Contact �ZZi'�, U�Ul��X1 , Email � 1/11�1'ii�v1:111�i(q�1'�.Mfil.l�
Address W� �I�DI�"I ��'Q.C�. �'��1I('M�x y�,1�1�1� �'c3Q'L2 �
� State Credentia[#'s �b11.1� �,�Ic,l O°�,,, , �
Dw+elling CoAfractor Qualifier# Dwelling ConCactor�i Building Contrector Registration!{
AcBitect/ � Company Name � Phone � �
Designer �
Contact Emai( � �
Address � �
Per�pit T�►pe Residendal Sin�le Family Residenrial Duplex Commerciel Multifamily Industrial
Catagory New Addition Alteration ��.
Project
Deacription
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Mechanical Separate perntits will be obtained for the following:
Permits $lectrical by Ptumbing by Headng by
Value of Jo6 $ �.�C`� (�,�(� �
(Velue f0[m8tari919 Bc 18bOC fS feQ.w ensure consislmcy in scce�siag permit Pees for ell applicants.)
Payment by: � Check # Cash it Fee Account � a _(�(^�
1'eevt{fy/he abova InJornwiion�s complere m�d nccurale. Asy devialloru fran!he p6ova su6n�red/r�fanlalio�►►rqy reqrdre addi(ionalpermils
ro bs obtainad I acbrnwledge ond agree lo these ler�.s.
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Name: k�.��,\(, m►1 l C (Please print) bate:`��c`� C5�-� r�j
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