HomeMy WebLinkAbout152301 - building (roof) 01 CITY OF OSHKOSH No 152301
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 770 KIRKWOOD DR Owner LEE R/SALLY POKLASNY Create Date 09/12/2012
Designer Contractor GEURTS CUSTOM HOMES INC
Inspector Nicole Krahn
Category 041 -Residential Roofing _ Plan -
Type • Building - 0 Sign 0 Canopy 0 Fence _ 0 Raze _ 1
Zoning R-1 _ _ Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection J
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 ' FR/TEAR OFF AND REPLACE EXISTING ROOFING ON THE HOUSE AND ATTACHED GARAGE DUE TO HAIL DAMAGE,NO
of Work STRUCTURAL CHANGES '"check#4222
HVAC Contractor Plumbing Contractor _
Electric Contractor
Fees: Valuation $ ,000.00 Plan Approval $0.00 Permit Fee Paid $60.00 Park Dedication $0.00
Issued By Orl Date 09/12/2012 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id#0654160000
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 a necessary royal •efore starting such activity.
I have read an. .nd, - e of entt ,• P •rmation. l7 7 ' 7 C _
Signatur t7 Date G��
Agent/Owner
Address 735 FOX FIRE DR Oshkosh WI 549041- 0000 Telephone Number (920)-6511599
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
Inspection Services Division
P O Box 1130
Oshkosh,WI 54903-1130
Phone: (920)236-5050 OIHKOf H
Fax:(920)236-5084
Roofing & Siding Permit Application ON THE WATER
• 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 n
JOB ADDRESS 716 l pj - rc ',\
OWNER Poo 5/v/
CONTRACTOR & if C--(I S427/4-1 Lk - t r
I am the: ❑ Owner OR contractor
USA CATEGORY
Ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Work being done:
ROOFING
Tear off and replace existing roofing onuse,Xarage
❑Replace wood decking
❑Add 1 layer of roofing to the existing layer(s)on❑house,❑garage
This work is being done due t-Hail 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:
1) ❑Electric-Existing Electric Meter,receptacle,lighting and Electric Service entrance alterations/modifications are being performed
by
(Nance of Licensed Electric Contractor)
AND ❑Electric Installation Verification form is attached OR ❑Separate Elect Permit will be requested.
2) ❑Electric-Not Applicable because: ❑i Blocks previously installed. ❑No outside lights. ❑Other
❑Install new or❑Replace gutters
❑Install new or❑Replace downspouts
Other related work being done: (please note)
Value of the job $ (include fair market price for labor even if you are not paying for labor) 03/02