HomeMy WebLinkAbout0152297 - Building (roof) l CITY OF OSHKOSH No 152297
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1870 WHITE SWAN DR Owner JEREMY R PROBST/JENNIFER M BURKHOLDER Create Date 09/11/2012 _
Designer Contractor TRINITY EXTERIORS INC _
Inspector John Zarate
Category 041 -Residential Roofing Plan
Type 0 Building 0 Sign O Canopy O Fence O Raze 1
Zoning R-1 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 0 Poured Concrete 0 Floating Slab O Pier 0 Other
O Concrete Block 0 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 reroof on house
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $8,900.00 Plan Approval $0.00 Permit Fee Paid $81.00 Park Dedication $0.00
Issued By: 4, Date 09/11/2012
Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 1523630000
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 under.-nd the afo;,,,,i.• tioned information
Signature ��`�,�� �---� Date ? /n -12--Agent/Owner
Address 4204 PARK GLEN RD ST LOUIS PARK MN 55416 - 0000 Telephone Number 952-920-9520
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.
City of Oshkosh
Fl
Inspection Services Division
POBox 1130
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Pax:(920)236-5084 1 O/I I
Roofing & Siding Permit Application ��THE wATFR
• 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$100,00 plus the
normal permit fee,which ever is greater.
OR
if you arse a contrcctor participating in the ermit fee Account System and have adequate funds, check here
ifyou want this processed through your account El
JOB ADDRESS .1 /5 70 LJk S A -
OWNER t7err`ern.y ?r_b bs 4
CONTRACTOR ti rx 4ter:ce S t1 c .
I am the: 0 Owner OR ,Contractor
USE CATEGORY
Single Family ❑Duplex ❑Multi-Family ❑Rental 0 Commercial ❑Industrial
Work being done:
ROOFING
rear off and replace existing roofing on house,0 garage
❑Replace wood decking
❑Add I layer of roofing to the existing layer(s)on❑house,❑garage
This work is being done due to L41ail Damage ❑Other
SIDING
❑Install siding on ❑house, ❑garage
❑Replacing vinyl with vinyl
0 Replacing steel or aluminum with vinyl(circle steel or aluminum)
❑ Replacing with
This work is being done due to❑Hail Damage In Other
siding is done, one of the boxes below must be checked:
I) ❑Electric—Existing Electric Meter,receptacle,Iighting and Electric Service entrance alterations/modifications are being performed
by
(Nazne of Licensed Electric Contractor)
AND G Electric Installation Verification form is attached OR :Separate Elect Pen-nit will be requested.
2) ❑Electric—Not Applicable because: ")Blocks previously installed. E No outside lights. 0 Other
❑Install new or❑Replace gutters
❑Install new or 0 Replace downspouts
Other related work being done: (please note)
•
Value of the job$ g ct 00 . 00 (include fair market price for labor even if you are not paying for labor) 03/02
............_.