HomeMy WebLinkAbout0158377-Building (driveway expansion) � CITY OF OSHKOSH No 158377
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1631 JEFFERSON ST Owner CLARITY CARE INC Create Date 10/21/2013
Designer Contractor BADGER HIGHWAYS
Inspector John Zarate
Category 256-Residential Driveway Pian
Type � Building � Sign_ 0 Canopy � Fence � Raze J
Zoning R-2 Ciass 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
� 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 RES/Driveway expansion*to include a flare to match the new garage width. �
of Work
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HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $2,473.00 Plan Approval $0.00 Permit Fee Paid $76.00 Park Dedication $0.00
Issued By: � Date 10/21/2013 Final/O.P. 00/00/0000
� Permit Voided, Parcel Id# 1504790100
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 necessa approvals before starting such activity.
I have read and under the o ention rmation.
Signature Date x��-ai�i3
� AgenUOwner
Address PO BOX 358 MENASHA WI 54952 - 0000 Telephone Number 920-739-7754
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
� �ll,y �f OS!L��SI G Oshkosh,WI 54903-1130
� Phone:(920)236-5050
F�:(920)236-5084
� Building Permit Application �'H'�'•ci.oshkosh.wi.us
Project / ,�—
Address /{j�j' ���C�,_,pY�
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name G'L}4/z/�� C.f�fZC Phone 9�D ��-6560
Tenant
Address ��i y � ,-�- Email
Contractor Company Name �p(.,F,,� �Gij,,�r�� ��, Phone
Contact Email
Address
State Credential#'s , ,
Dwelling ConU•actor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Ty e esidential Single Famil Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alterat�on
Project � ( y� a S q � Q r ek,c, U C) 1 �
Description
1 .
�X�a n S��,�. �-� �x�5-�-, ►�.e. �r�v e �
Mechanical Separate permits will be obtained for the following:
Permits Electrical b
y F'�/jG Plumbing by_1j/�jq Heating by
Value of Job $ '�y � 3 (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # 29)'� Cash Permit Fee Account
I certify tlte above inforn:ation is complete and accurate. Any deviations from the above subn:itted infornaation may require additiona/permirs
to be obtained. I acknox�ledge and agree to these terms.
Name: S n�ES �iq,pl/jit/ �/ /?� ,tg,p� (P�ease pr�nt) Date: /D -,�l-�3 :
Signature: