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HomeMy WebLinkAbout0158857-Building � CITY OF OSHKOSH No 158857 OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 2023 HAMILTON ST Owner DOLORES A REETZ Create Date 11/15/2013 Designer Contractor REBATH OF CENTRAL WISCONSW Inspector John Zarate Category * 140-Interior Remodeling Plan Type � Building 0 Sign_ � Canopy _ � Fence � Raze ' Zoning R-1 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 � Other 0 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/remove cast iron tub and install acylic shower with any necessary drywall repairs � of Work "debit acct** I II HVAC Contractor Plumbing Contractor Electric Contractor Fees: Valuation $5,272.00 Plan Approval $0.00 Permit Fee Paid $72.00 Park Dedication $0.00 Issued By: �� Date 11/21/2013 Final/O.P. 00/00/0000 ❑ Permit Voided i Parcel Id# 1213150000 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 230 N KOELLER ST OSHKOSH WI 54902 -4109 Telephone Number (920)303-5797 * 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. . Nov, 14. 2013 5: O1PM:�:...: REBATH CENTRAL WI 92030359�5 � : : . -No. 4765 P, 1/2� . ..... . .. .. . . . . .. . . . _,. .... , . . . .. . . ... .. , . . :, � ... , . . . , . . . . . ... ,: . � . . . . .. .... osh,an .; _ ..,..• . . . . C�t O OSFL�OS�'C . . . �.. ��.. .� . . y � . . . . . . . Oshlc 54903 1 i30' �. . . . . _ .. . . Phone:(9Z0)236-5050 • . • ' . � . . . . • . . . . Fa.r.(920)236-5084 . . : . .� - . . Bu�ding Per.�.i�App�ication. _ .,�,�.�osriko5�.w�.u� Pxo�ecr'' ana 3 :1-��lrnl�l�`2�/� �'f- . 5�g0/. � . =�d�res�s . � Applicant Ounier Contractor 'fena�t Orher(descnibe) �� . � �� . ,Own.er�: �� Name .�O�L�Ir� 'e � o��� ~-I�OQ� . ;: . �'hone � Te�ant` . . •- - _ Address �3 ���,�r1��" ��� Email . ' Contractor . . ► � � . • /� Compaciy N�ame L{ •-� �` � �., � � ') � Phone "(�ia �_�'?i -r�j Cj� Contac� l�f�_ . � I;mail I �z��re�(.f�'1�l Y�YlL�J_C�/Y1 r� In TI . ' Address G1�� �V���(�Y �1�'Y��_,.„����1�Q:�')'1 W� � ��'1��� . S�3teCredential�#,s � �`�s . , �a� ��91 ., � DwelliAg Cona�actor Qualifier# Dwellin�Cnnuactor� Bu;iding Coatractor lteeislration# Acbytect/ . Com aa Name�� �L l l f t'���� �_ . � DesiDner �n-y . �I��� � Ptiane ��J� o �����. . . . ^ . . . � Contact� .. . . Email - � . � aaa;�ss . . . . , . � Permit Type Rcs'zdential Singlc Family . : . Residential Duple�: Commercial Multifanuly Industrial . Cata�ory, . New. : Addition Alieration � �� =PrQj:e�t;:� . . . - r' Descisption'- ; ,.. : . o�a� � XiS�1 S� �r�l�.� . . . - . . — . . - . . �s�t.l ` . � I ' . � � -� . .1F�� . � � . . . . .. . _: .:::_ .I I . ��. � � � . : � � . . I , , . ,. .. . . . : . : _. _ . . . .__ . . . ._ ____ .___. _ . . . .._ Mech�nicai S.epar�ate.peimits.will be obtainzd for tE►e following: - . �. - � . . .� .....:...:. .. . � . : Permits: . ... --��- ...._t_._.._,.:... .. �.. . . - . - ._.,----..... ._:. :_�]ectz�s'�.b.�. . . .. .....:.:. .. . . .. PEum.binD by: ._: Heating:by ._....,..,:- ---� ....._. - ——.._......_..__......_..._.._.._....-- -� - �-- ---��.-- �-• • �valae�o�Jo� $.� 70/�.� (Valuc for matcrials.8c labor is req,to ensurs conriste _... ._.._.. .----it fees For all appiicanrs.)._.__... .. .... .. , _. ,....• _ �--- . -� � Paymec�t:by: . �; '�--Check # `�Cash ..:. :. PermitFee Account . � � lcert�the above infornrotion is complete and accur•a1e: Arry devialionsfram!he aLove svbmil[ed i.zfornratio.�►�ay requi�e additiortnl permir,c .. �o. ' bta'n�ed• !a .le e mid agreb ro these lernis.. . -• •:. I�Tame. `(� n • Q;;�.�D (Plcasc print) �, . Date: '' ' �� ,. . . .. ..... . . . .. .Signature: . . �.... ..�, : .. ... . � . . .. . ,