HomeMy WebLinkAbout0153539 - Building (roof) CITY OF OSHKOSH No 153539
41 OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER Create Date 11/13/2012
Job Address 2671 VILLAGE LN _ Owner RICHARD S/SHERRY L MADSEN —
Contractor PORTSIDE BUILDERS,INC.
Designer -- ---- - -- - -- --Inspector Nicole Krahn Plan
Category 041 -Residential Roofing —
Type Building 0 Si n
0 Canopy _-- Fence 0
--- Raze ----
'
---
Zoning R-3
Class of Const: Height Ft. Size�-- -- --Protection
Unfinished/Basement Sq.Ft. Rooms Canopies
Sq.Ft.
Finished/Living q• Bedrooms Stories— -
Pier O Other
Signs
Garage Sq.Ft. Baths _--_ --
Foundation • Poured Concrete 0 Floating Slab 0 — — — —
0 Concrete Block 0 Post 0 Treated Wood
0.00 Flood Plain Height Permit
Occupancy Permit Not Required Occupancy Fee _--- __
0 #Structures _ 0
Park Dedication #Dwelling Units —
Use/Nature OFR/Tear off and replace existing roofing on house only. No structural changes.
of Work
-----------
Plumbing Contractor _ — --
HVAC Contractor
Electric Contractor
------------------- -----
-
Fees: Valuation $12,000.00 Plan Approval $0.00 Permit Fee Paid $100.00 Park Dedication
Date 11/13/2012 Fine110.P. 00/00/0000
Issued By: Permit Voided Parcel Id# 1320510500
�
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 aparovals before starting such activity.
I have read aria derrsssttand the re enti ned in . -tioy Date r'1// //2
Signature t��X,�:�l��t
Agent/Owner
NEENAH WI 54956 - 1363 Telephone Number 920-727-4874
Address 980 AMERICAN DR _— — __._ — —
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Name Number,Type
peo of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your
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 ON ON rtwF,` I—
ur`�T�F>t
Fax:(920)236-5084 Application
& Siding Permit App cao
• Application(s)and fee(s) can be brought to City I Room wimaesult in Inspection Services,fees being doubled o $100.00 pgus the
Oshkosh WI 54903-1128. Commencing
normal permit fee,which ever is greater.
OR
I ou are a contractor sartici,atiJ in the Permit ree Account S stem and have adesuate unds check here
i ou want this •rocessed throufh our
JOB ADDRESS C., 't ' k I I_.
OWNER C. < yykk
CONTRACTOR
I am the: ❑ Owner OR %Contractor
3.13E CATEGORY ❑Rental ❑Commercial ❑Industrial
Single Family ❑Duplex ❑Multi-Family
Work being done:
ROOFING
115■Tear off and replace existing roofing on!$'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
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
(Name of Licensed Electric Contractor)
AND ❑Electric Installation Verification form is attached OR L 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
Other related work being done: (please note)
Value of the job$ 1 2 OOC'` (include fair market price for labor even if you are not paying for labor)
03/02