HomeMy WebLinkAbout0095117-Building (roof) CITY OF OSHKOSH No 0095117
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1930 SIMPSON ST Owner LUCILLE E MILLER Create Date 06/14/2002
Designer Contractor LAKEWOOD ROOFING
Category 141 - Exterior Remodeling Plan
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze
Zoning Class of Const: Size
Unfinished /Basement 0 Sq. Ft. Rooms 0 Height 0 Ft. ❑ Projection I
Finished /Living 0 Sq. Ft. Bedrooms 0 Stories Canopies 0
Garage 0 Sq. Ft. Baths 0 Signs 0
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupancy Permit Not Required Flood Plain Height Permit
Park Dedication # Dwelling Units 0 # Structures 0
Use /Nature SFR/ Tear off and replace existing roof on house, due to hail damage. *NO STRUCTURAL WORK.
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $4,150.00 Plan Approval $0.00 Permit Fee Paid $40.00 Park Dedication $0.00
Issued By: kYV‘ Date 06/14/2002 Final /O.P. 00 /00 /0000
❑ Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature 0 �..._e- Date 67 /'1/0 -- \__
Agent/Owner
Address P.O. BOX 15 WINNEBAGO WI 54985 - 0015 Telephone Number 235 -1955
Check all applicable boxes and fill out as much information as possible. Thank you.
1 Address of Property A'1 3 O S , S,O d.
2 The Property is owned by Lk-) t k t � (k (
3 I am the ❑ Owner OR I am the - Contractor
4 The contractor doing the work is L0-4=4_ A.o Z rc.
5 This is angle Family Residence, ❑ Rental, ❑ Commercial
6 Work being done:
ROOFING
Ori ear off and replace existing roofing on.. house, L garage
❑ Replace wood decking
❑ Add 1 layer of roofing to the existing layer(s) on ❑ house, ❑ garage
This work is being done due to4ai1 Damage ❑ Other
SIDING
❑ Install siding on ❑ house, ❑ garage
❑ Replacing vinyl with vinyl
❑ Replacing steel or aluminum with vinyl (circle steel or aluminum)
❑ Replacing with
This work is being.done due to ❑ Hail Damage ❑ Other
When siding is done, one of the boxes below must be checked:
❑ Electric — Electric Meter, receptacle, lighting and Electric Service entrance
alterations /modifications are being performed by
Electric Installation Verification form is attached (Name of Licensed Electric Contractor)
❑ Electric — not applicable
•
❑ Install new or ❑ Replace gutters
❑ Install new or ❑ Replace downspouts
❑ Other work being done: (please note)
Value of the job A,,,--(:).P0 1 include fair market price for labor even if you are
not paying for labor)