HomeMy WebLinkAbout0159046-Building � CITY OF OSHKOSH No �ssoas
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OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1130 N WESTFIELD ST Create Date 12/12/2013
Project Bathroom Remodel ___ Project Number 20130702
Owner EVERGREEN RETIREMENT COMM INC Plan
Contractor PACKER VALLEY BUILDERS, INC
Inspector Nicole Krahn
Designer
Category 220-Alteration Hospitals&Institutions Type of Plan
Zoning R-1 Square Footage '
Major Occ Const Class
Fire Protection � Sprinkled � Unsprinkled � Sprinkler Design
Occupancy Permit Not Required Flood Plain Height Permit
Park Dedication ___ #Dwelling Units 0 #Structures 0
� Projection �, Ca�opies Signs
Use/Nature
of Work
�COMM/Remodeling the existing bathroom per the plans submitted. The 1 hr separation will be maintained. New walk-in shower,vanity and flooring• I
Seperate permits will be required for the electrical and plumbing work.
I
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HVAC Contractor _ _ Plumbing Contractor J RASMUSSEN PLUMBING INC
Electric Contractor BEEZ ELECTRIC INC
Fees: Valuation $5,000.00 Plan Approvai $0.00 Permit Fee Paid $65.00 Park Dedication $0.00
Issued By: �'�. Date 12/12/2013 Final/O.P. 00/00/0000
❑ Permit Voided'I Parcel Id# 1615311000
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 secur esser�eppreve efore starting such activity.
I have r d a d e menf ned info ation. `� /���
Signat Date
AgenUOwner
Address 2277 CLAIRVILLE ROAD OSHKOSH WI 54904 - 0000 Telephone Number 920-232-7620
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.
13-12-11 15:23 Packer Valley/Nekimi 920 232 7622 » P 1/4
� Cit1 ef Osh�osh p��°X 130
Oshkosh,WI 54903-1130
� Ahonc:(920)236-SO50
Fax:(920)?36-SQ84
Bui�ding Permit A.pplication ''""',°.�`''`°`�."'�'s
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Applicaot Owner Con Tcttant Othcr(describe)
Tnaat/ Name�„�* !t�/' a.11 ��� P�� /i� Phono ��� ' %�a� �
Addresso�oc �� �',(�Gt«r�:l�G �O^ ���C,"S� Emajl
Contractor ,� /�
Company Name (l� �'��� c� ���� ,Uc.•�G���s' �nc, Phone�_�o�' '��o��
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Contact '
Email
Address .r�,:� '�%�� � 1G��i'v. �/� ;,t�'�d� G:�S""ij.�'�'J S� C✓/
s�t�cnd�,����s 9s�q 9 D6 `� �' 9,3
Dwcliing Con�'tra�tor Qualifiet N � Dwelling Cootrpctot� � $uildQtg Contractor Regist:ation�!
AchiteCt/
Dcsigner Company Name Phone
Contact
Email
Address '
P�rmit Typc R�sidential Single Family Rcsidentisl Duplox Commcrcial Multif�mily lndu�tria!
Caagor!' New Addition Alteratio
Project �x�� ' � �/�
�lSCriQLjOp /Od�-- �'� Q/J LLrn 7k.,�1
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�°l.✓ wa�� �`ti S �tOe./ �i" /JC°ea/ �/Cd�' ��
MecdAOial Separate permitS will be obta.ined for the following:
Pcrmits Elecaical b ���
Y_ � Plumbing by�/�.4.SS�-�. Heating by
Value Of Job a ��pd� �" �y��for materials&labor is oo e�ure
i'W c��acY�n aCOeasutg p�rmit foes Cot ell eppli�mots.)
Payment by: Check #4� �h pecmn Fa qc�ount
/cert�tlu above injormorion!s eomple�t and accuro�c. Arry devreraru fronr tht above sabmlaed lyfoinwtion r�nqnJn addlrlona/pamlv
�o bc oblclncd. 1 ackriowkdgr ond agree ro lhese�erms,
Name• (Pleasc pr;nQ Datc: �.������
Signatu .