HomeMy WebLinkAbout2014-Building � CITY OF OSHKOSH No 158861
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1305 PIERCE AVE Owner KEITH UDIANE D ROBERTS Create Date 11/21/2013
Designer Contractor PEAK TO PLATE BUILDERS LLC
inspector Nicole Krahn
Category * 140-Interior Remodeli�_ ____ Plan
Type � Building � Sign � Canopy � Fence � Raze
— -
Zoning R-1 Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection j
Finished/Living Sq.Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation � Poured Concrete � Floating Slab � Pier � Other
� Concrete Block � Post 0 Treated Wood -- --
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dweiling Units 0 #Structures 0
Use/Nature SFR\Kitchen remodel-cabinets,flooring,exterior door - ,
of Work
�--- -------- ---------- -----
HVAC Contractor Plumbing Contractor QUANDT PLUMBING LLC
Electric Contractor
Fees: Valuation $14,342.00 Plan Approval $0.00 Permit Fee Paid $130.00 Park Dedication $0.00
Issued By: �j���� Date 11/21/2013 Final/O.P. 00/00/0000
❑ Permit Voided'' Parcel Id# 1604260000
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 und nd the afore mentioned information.
Signature`� Date ( z�
AgenUOwner
Address 16 W NEW YORK AVE OSHKOSH WI 54901 - Telephone Number 920-312-3465
* 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 speciFed 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 L Oshkosh,WI 54903-1130
� Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application ���►.oshkosh.w;.us
Project �� � ! �0 S /', �
Address Pll� U�
Applicant Owner Tenant Other(describe)
Owner/ Name ���a n c flfa�Pr��U c-- Phone
Tenant
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Address 1305 ?rC/�Ct �✓'�- Email
Contractor Company Name �C�� �a ���7�C ����TS. Phone � �- 3�2 - 3�/�s—
Contact ���tGt��l+� ����5'u« Email__ �7���c�l��c.��
Address �� � OVP�,.� v/d,,� f�c-
State Credential#'s ( �Z��� , ��Z�� � ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type ' ential Si Residential Duplex Commercial Multifamily Industrial
Catagory New Addition t
Project �� f��fG�eG. (��,hc�"S , �f'`�di� xs G� ���i'rt�� �°.� ����p�c.�-��
Description
Mechanical Separate permits will be obtained for the following: ���� �/ �
Permits b
Electrical by �w� Plumbing by .,,�t. � Heating by
Value of Job �f,
$ ��Z' �/� (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # �5�� Cash Permit Fee Account
I certify the above inforn:ation is co»�plete and accurate. Any deviations from the above submitted information may requir•e additional permits
to be obtained. 1 acknowledge and agree to these terms.
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Name: e,�l�tM.,�,� ��.tHye�..� (Pleaseprint) Date: �(�j� �/�
Signature: