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HomeMy WebLinkAbout0146639-Building (roof) g CITY OF OSHKOSH No 146639 OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1710 CRYSTAL SPRINGS Owner DALE E KUSSROW Create Date 07/01/2011 Designer Contractor BB CONSTRUCTION Inspector Nicole Krahn Category * 141 - Exterior Remodeling Plan Type 0 Building 0 Sign 0 Canopy 0 Fence 0 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 0 Floating Slab 0 Pier 0 Other 0 Concrete Block 0 Post 0 Treated Wood Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit Not Required Park Dedication Not Required # Dwelling Units 0 # Structures 0 Use /Nature SFR / TEAR OFF AND REPLACE EXISTING ROOFING ON THE DETACHED GARAGE ONLY, NO STRUCTURAL CHANGES of Work **check #7066 HVAC Contractor Plumbing Contractor Electric Contractor Fees: Valuation $1,500.00 Plan Approval $0.00 Permit Fee Paid $32.00 Park Dedication $0.00 Issued By: cY Date 07/01/2011 Final /O.P. 00 /00 /0000 ❑ Permit Voided I Parcel Id # 1309210000 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 easem= restrictions of which it is not a party, if you perform the work described in this permit application within an easeme • , ' = ity trongly urges the permit applicant to contact the easement holder(s) and to se re any necessary ap• , •vals •-for= -tarti • such activity. I have read and • - rstand the - • e - ion=. inf• �•- _ '• .. / Signature ° /,�.` -�� Date �( // P Pr Agent/Owner Address 521A N 4TH AVE ir REDGRANITE WI 54970 - 0000 Telephone Number 920 - 290 -0127 * 141 - Exterior Remodeling See ' jir p ter 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. `� o Le LP City of Oshkosh Inspection Services Division PO Box 1130 Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 OfHKO1 Fax: (920) 236 -5084 ON THE WATER 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 Permit fee Account System and have adequate funds, check here if you want this processed through your account F1 JOB ADDRESS 1 1 71 /0 Cal 51.4 / gra t OWNER DA le (C <S5 2'02.) CONTRACTOR j - p j ` sc),n Scc---JZ. 4 d , (9_,) I am the: ❑ Owner OR contractor U E CATEGORY amily ❑ Duplex ❑ Multi - Family ❑ Rental ❑ Commercial ❑ Industrial Work being done: ROOFING 0 i/ and replace existing roofing on ❑ 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 %other e_ SIDING // tvv/ ❑ 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: 1) ❑ Electric — Existing Electric Meter, receptacle, lighting and Electric Service entrance alterations/modifications are being performed by (Name of Licensed Electric Contractor) AND ❑ Electric Installation Verification form is attached OR ❑ Separate Elect Permit will be requested. 2) ❑ Electric — Not Applicable because: ❑ J Blocks previously installed. ❑ No outside lights. ❑ Other ❑ Install new or ❑ Replace gutters ❑ Install new or ❑ Replace downspouts C. Other related work being done: (please note) m Value of the job $ / 2 0 (include price y paying ) include fair market rice for labor even if you are not for labor) 03/02