HomeMy WebLinkAbout0158692-Building (windows) � CITY OF OSHKOSH No �ssss2
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 503AMHERSTAVE Owner PINE MOUNTAIN INVESTMENTS LLC Create Date 11/11/2013
Designer Contractor J FINK CONSTRUCTION
Inspector John Zarate
Category 040-Windows Pian
Type � Building � Sign � Canopy � Fence � Raze I
Zoning R-2PD 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 0 Other
� Concrete Block 0 Post � Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit Not Required
Park Dedication Not Required #Dwelling Units 0 #Structures 0
Use/Nature ,SFR/INSTALL(10)REPLACEMENT WINDOWS IN EXISITNG OPENINGS(SAME SIZE)-NO STRUCTURAL CHANGES �
of Work I,
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HVAC Contractor Plumbing Contractor
Electric Cont�actor
Fees: Valuation $2,500.00 Plan Approval $0.00 Permit Fee Paid $51.00 Park Dedication $0.00
Issued By: � --- Date 11/11/2013 Final/O.P. 00/00/0000
� Permit Voided I� Parcel Id#0702070000
In the performance of this work I agree to perForm all work pursuant to rules governing the described construction.
While the Ciry 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 t afore mention�information.
Signature Date /J//–�3
�*—�—
AgenUOwner
Address 1018 JACKSON ST OSHKOSH WI 54901 - 3712 Telephone Number (920)379-0793
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 Box1130
ClLy �f OSlL��S� Oshkosh,WI 54903-1130
� Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application WWW���.oshkosh.W�.us
Project C J r,� ,� Cor�s c. ��.,
Address �JO� �r,.��
Applicant Owner Contracto Tenant Other(describe)
Owner/ Name '
Tenant �1�'G"`� ��`'�' � l�i;�.-�� ,f��6�-`�e'r Phone
Address Email
Contractor Company Name /�� �� � (' .,�_ � �3
�,.a Phone �iav1 3�/-�
Contact �05� Email ��,-���;\_ 6����,x�. Cor�,
Address ��/� ���SOz- S° - 1��l�v���-a���
State Credential#'s
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Dwelling Contractor Qualifi r# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer :
Contact Email
Address
Permit Type esidential Single Family Residential Duplex Commercial Multifamily Industrial :
Catagory New Addition teration
Project � ��
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job $ �S� alue for materials&labor is .to ensure consistenc in accessin
(V y g permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I certify the above information is complete and accurate. Any deviations from the above submitted information may requir•e additional permits
to be obtained. I acknowledge and agree to these terms.
Name: -a v�� �ii �� �� (Please print) Date: ��'��I�
Signature: -