HomeMy WebLinkAbout0158826-Building � CITY OF OSHKOSH No �58s2s
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 432 BROAD ST Owner SALLY M MARX Create Date 11/19/2013
Designer Contractor HOMESTEAD BUILDERS LLC
Inspector John Zarate
Category * 140-Interior Remodeling Plan
Type � Building � Sign � Canopy � Fence _ � Raze _ !
Zoning C-3 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 � 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 SFR\Remodel bath in existing space-replacing tub tub with shower
of Work !I
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HVAC Contractor Plumbing Contractor L.C. PLUMBING INC. ,
Electric Contractor
Fees: Valuation $3,500.00 Plan Approval $0.00 Permit Fee Paid $58.00 Park Dedication $0.00
Issued By: L�-� Date 11/19/2013 Final/O.P. 00/00/0000
� Permit Voided� Parcel Id#0406240000
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 activiry.
I have read a d under nd the ormation.
Signature Date
� � AgenUOwner
Address 5669 ANGLE RD OSHKOSH WI 54904 - 6855 Telephone Number 920-410-5117
* 140-Interior Remodeling See Chapter NR 447 of the Wisconsin Administrative Code and Notification Form 4500-113 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
� l�l�y �f OS���SI G Oshkosh,WI 54903-I 130
� Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application �W���.oshkosh.W�.us
Project (�
Address ( � � �Y Q�� �T-
Applicant Owner Contractor Tenant Other(describe) -
Owner/ Name Phone
Tenant
Address Email
Contractor Company Name �O��57`P�'"�� �;,q���¢.-5 �-�- Phone �ZU - �{(C� - �l/�
Contact �`-I-��- ���`^� �� Email
Address �2� ✓� l�;�-�5 �� �
State Credential#'s , ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type esidential Single Famil esidential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteratio
Project ���� ����
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by ��- p�i.�i���_ Heating by
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Value of Job $ �� 7� �'
( (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # ��g�Cash Permit Fee Account
I certify the above information is complete and accurate. Any deviations from the above subn:itted information may requir•e additional permits
to be obtained. I acknowledge and agree to these terms.
Name: f`�P.v� ���-+1`�� (Please print) Date: (��- � �— ��
Signature: ,��"'�