HomeMy WebLinkAbout2013-Building � CITY OF OSHKOSH No 158700
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 960 MARICOPA DR Owner ROBERT D/SUSAN M WHITTAKER Create Date 11/11/2013
Designer Contractor NATHAN POTRATZ CUSTOM CARPENTRY LLC
Inspector Nicole Krahn
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence � Raze
2oning R-1 _ Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection I
Finished/Living Sq.Ft. Bedrooms _ Stories _ Canopies
Garage Sq.Ft. Baths Signs
Foundation � Poured Concrete 0 Floating Slab 0 Pier � Other
� Concrete Block � Post � Treated Wood
Occupancy Permit Occupancy Fee $0.00 Fiood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR/remodeling kitchen to include new cabinets and countertop/no walls being added or opened/all work will meet state and local '
of Work Icodes/separate permit erquired for plumbing
,
I i
,
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation __ $22,820.00 Plan Approval $0.00 Permit Fee Paid $170.50 Park Dedication $0.00
Issued By: --•ay , Date 11/11/2013 Final/O.P. 00/00/0000
� Permit Voided� Parcei Id# 1312850000 '
In the performance of this work I agree to perform al!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 pertorm 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 und st th�entioned information.
Signature �ate 1�� 1�- l�3
.
AgenUOwner
Address 6857 MOUNTAIN RD PICKETT WI 54964 - 9560 Telephone Number 920-410-4146
* 140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500-313 on the DNR
Asbestos Program website;http://dnr.wi.gov/air/compenf/asbestos/.For additional information on hazards present in buildings see
the Pre-Demolition Environmental Checklist at http://dnr.wi.gov/org/aw/wm/publications/anewpub/WA651.pdf
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
C'lty �f�s���s� Oshkosh,WI 54903-1130
� Phone:(920)236-5050 '
F�: (920)236-5084
Building Permit Application �W���.oshkosh.w;.us
Project r� (�
Address 9(p � /'"l a�i�p p� ��c
Applicaur Owner Contractor Tenant Other(describe)
Owner/
Name g o � S u s<<� I,c��,.`�-lQu kc� Phone
Tenant
Address ��OD I�a c`t��1. � � Email
Contractor Company Name �a'�-•a.� ��'�-�'a-�2 �'�,s�o✓7 (��.�c�e�c�phone Q��- �l k�-�f/�/b
Contact ��a� �o�u�_ Email ►ta�a� �o'��'.c�� �o�,.•��`��.co�
Address b'�S" 7 l�f,�u��'a.�- �d� �?c �.e'��- 1.J"1` J�f Q L c(
State Credential#'s !v �! �'�g�S , �(��� �C�O ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name --Pkione
Designer -,.._:.:_:__. .
_,___.._--___-- -- _
Contact ' Emai l � �
Address
Permit Type esidential Single Family 'Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project � .r���e,�. Ca b<<�e-�s �— C'6 v� -t-e�--�-s�-�
Description
� �
o�C. �- ,--
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by �KS�,�S�e(� Q��."^�'f�Heating by
Value of Job
$ �o2, �v� � (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # �s�� Cash Permit Fee Account
1 certify the above information is co»:plete and accurate. Any deviations from the above subn:itted information may requir�e additional pennits
to be obt 'ned. I ac,6�nowledg and agre to these terms.
Name: �V'�-�4 a.� '(��+- � (Please print) Date: �l ' ��' ��
Signature: