HomeMy WebLinkAbout0145728-Building (roof) CITY OF OSHKOSH No 145728
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1240 WHEATFIELD WAY Owner DALE A/HEIDI R ROBERTSON Create Date 05/04/2011
Designer Contractor HICKEY ROOFING
Inspector Nicole Krahn
Category * 141 - Exterior Remodeling Plan
Type • Building O Sign O Canopy O Fence O Raze
Zoning 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 O Floating Slab O Pier 0 Other
O Concrete Block O Post O Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication # Dwelling Units 0 # Structures 0
Use /Nature SFR / Tear off and replace roof on house and garage. * *debit acct
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation ���� ____ $7,081.00 Plan Approval $0.00 Permit Fee Paid $74.00 Park Dedication $0.00
Issued By: Gv�`( /J Date 05/04/2011 Final /O.P. 00 /00 /0000
❑ Permit Voided Parcel Id # 1340440000
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
Agent/Owner
Address 1427 BROAD ST OSHKOSH WI 54901 - 3047 Telephone Number (920) 426 -4008
* 141 - Exterior 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.
y 03 11 06:04p HICKEY ROOFING 9202320354 p.1
City of Oshkosh
Inspection Services Division
P O Box 1130
€
Oshkosh, WI 54903 -1130
Phone: (920)6- 508450 01HKOJN
Fax: (920)236 -5084
ON THE WATFR
Roofing & Siding Permit Application
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Perini fee Account System and have adequate funds, check her
if you want this processed through your account
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JOB ADDRESS //�j .4 /6 t/J ai _
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OWNER d��Yrti'� r�/ /�Zt% f7�
CONTRACTOR 1- JG /�y �UCI L-
I am the: ❑ Owner OR XContractor
UyE CATEGORY
Single Family ❑ Duplex ❑ Multi- Family ❑ Rental ❑ Commercial ❑ Industrial
Work being done:
ROOFING
/Tear off and replace existing roofing ojett house, garage
❑ Replace wood decking
❑ Add 1 layer of roofing to the existing layer(s) on ❑ house, ❑ garage
This work is being done due to ❑ Hail Damage 0 Other
SIDING
❑ Install siding on ❑ house, ❑ garage
0 Replacing vinyl with vinyl
0 Replacing steel or aluminum with vinyl (circle steel or aluminum)
O Replacing with
This work is being done due to ❑ Hail Damage ❑ Other
When siding is done, one of the boxes below must be checked:
1) 0 Electric — Existing Electric Meter, receptacle, lighting and Electric Service entrance alterations/modifications are being performed
by
((Name of Licensed Electric Contractor)
AND .: Elect is Installation Verification form is attached OR Separate Elect Permit will be requested.
2) 0 Electric— Not Applicable because: ; ' J Blocks previously installed. '_i No outside lights. I 1 Other
❑ install new or ❑ Replace gutters
❑ Install new or 0 Replace downspouts
Other related work being done: (please note)
62 i
Value of the job $ 9/1-' / (include fair market price for labor even if you are not paying for labor) 03/02
Received Time May. 3. 2011 6:02PM No. 5514