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� CITY OF OSHKOSH No 158303 �
: OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD �
ON THE WATER '
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Job Address 603 CEAPE AVE Owner BREFCZYNSKI INVESTMENTS LLC Create Date 10/16/2013
Designer Contractor WINDOW WORLD OF MILWAUKEE
inspector John Zarate
Category 040-Windows Plan
Type � Building � Sign _ � Canopy_ � Fence � Raze __J
2oning R-4 Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection
t
Finished/Living Sq.Ft. Bedrooms Stories Canopies
Garage __ Sq.Ft. Baths ___ Signs
Foundation � Poured Concrete � Floating Slab � Pier � Other
� Concrete Block � Post � Treated Wood ---. --
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit Not Required
Park Dedication Not Required #Dweliing Units 0 #Structures 0
Use/Nature SFR/INSTALL(3)REPLACEMENT WINDOWS IN EXISTING OPENINGS-NO STRUCTURAL CHANGES "debit acct �
of Work
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I
_ .___.__""-_- - -_-_- -_- _JI
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $1,489.00 Plan Approval $0.00 Permit Fee Paid $44.00 Park Dedication $0.00
Issued By:�� Date 10l16/2013 Final/O.P. 00/00/0000
� Permit Voided '� Parcel Id#0801110000
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 othervvise,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.
10-16 '13 13;28 F�OM- T-407 P0002/0003 F-748 �
. P O Box 1130
� ��� � �S���s,/L OsWcosh,WI54903•1130 i
y f phone:(920)236-5030 `
� Fax:(9Z0)236•5084 . '
• • • • - www.ci.oahkoeh.wl.us `
Bu�lding Permit App�cat�on
Project _�� �t l.lJ,�� l��C' C'�Sh I��Sh YV I �!-Y-f-�'/p� `
Address� `
Apptic�nt Ownor Contracto Tenant Othex(describe)
Owner/ Name ( (C'f' �r�e F e z u ns�� Phone � o� U �J��CI � 7�
Tenant
Address�C��S �� ��{� �,n�1_� �..11 l �I��ail� ( �,�U� ,
Contrsetor Company�Name�,�(�1 VV''l�(�l�l �� ��I�1I II��P I LC_ Phone Z�2��;,�-'Tv�
Contact L.a7.2..1'(�. �,�fl��X1 �mail,�b�V1l�Y1+��11��Q��'1P MGI.I�-�
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Address�pU, ��,�-� ,�,��- c�eJ,('1]OC�.��LI ��pZd2 �
� sta�c��a�t��#°s �3b►�a � , �3��o°� , ; ;
Dwelliag Contractor Qualifier�# Dwalling Contractor# Bullding Coptractor Registration�l
Ac6itect/ � �mpany Name � Pbone
Designer
Contact Bmail �
Address �
Permit Type �tesidential Single Family Residentiai Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration �}-
Project .
Descriptioa
.� �
Mecbanicel Scparate perntits will be obtained for the follov�rIng;
P�'� Electrlcal by Plumbing by Heating by
ValueofJob � 14,c6G,pp
(Vatue for metsrials&labar is req,to ensure cousistency in accessiag per�nit fees for all applicanis�)
Payment by: Check # Cash ermit Fee Account �
1 cerl�fy l/te above lnfo►�ation is complele mtd accumle. Any dsvlailons frorn�he a6ove au6milred i►dformallon nuZY reqrdrs add��iona/per►n/lo
�o be o6la t� I eck►wwle e and agr�es l0 lhere tenns.
Name: �� S (Please print) Date: ���I �
Si�tature: 1� D��Q��