HomeMy WebLinkAbout0158262-Building � CITY OF OSHKOSH No 158262
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3770 GLENKIRK LN Owner VACANT Create Date 10/01/2013
Designer Contractor M.R.TEAS INC
Inspector Nicole Krahn
Category 134-New Mobile Home Plan
Type � Building 0 Sign � Canopy � Fence � Raze �I
Zoning Ciass of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection , .
Finished/Living 1193 Sq.Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation � Poured Concrete � 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 Mobile Home/Install Concrete slab 15'4"X 78'with new mobile home 15'-4"x 78'. Scope of work also includes two 4'x 4'concrete slabs
of Work ��for entry platforms per approved site plan.
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HVAC Contractor Plumbing CoMractor
Electric Contractor
Fees: Valu tion $45,000.00 Plan Approval $0.00 Permit Fee Paid $239.74 Park Dedication $0.00
Issued By: � Date 10/15/2013 Final/O.P. 00/00/0000
❑ Permit Voided'j Parcel Id# 1278400000
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 mentio ed information.
Signature . e�„_ Date % -- 5- 3
AgenUOwner
Address 706 WOODENSHORE RD NEENAH WI 54956 - 9747 Telephone Number (920)720-2288
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
Cl-1-y Of OS��OS� Oshkosh,WI 54903-1130
� �' Phone:(920)236 5050
F�:(920)236-5084
Building Permit Application �'�'�'•ci.oshkosh.W►.�s :
Project
Address ���� ��.p,y����
Applicant Owner Contractor Tenant Other( escribe) ����'��Y�['�,Q1
Owner/ Name Phone
Tenant
Address Email
Contractor Company Name 'c�►� `� Phone q a�- �� - �ol.�
C t�l. �. �s
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 Go`�C.,6'�ay�`�. _��� 'C"D(� '`(`t��a���\i 1Q� �,orn�� . S1otb U7� `� � �
Description �>> �
15�'� X 7g � ^ '�x'� �ex�'�r�.� a�.00 r � ?o��
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job �J �7
$�T'J���.�t/ (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 complete and accurate. Anv deviations from the above submitted information may require additional per•mits
to be obtained. I acknowledge and agree to these terms.
, ��_� _�3 .
Name: �_.>�i��1� C���'�Q��� (Please print) Date:
Signature: