HomeMy WebLinkAbout0155214 - Building (roof) la) CITY OF OSHKOSH No 155214
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 249 W 17TH AVE Owner TERRY USARAH R RUSHING Create Date 04/23/2013
Designer Contractor OWNER
Inspector Nicole Krahn
Category 041 -Residential Roofing Plan
Type • Building 0 Sign ❑ Canopy ❑ Fence ❑ Raze
Zoning R-2 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 ❑ Pier 0 Other
❑ Concrete Block ❑ Post ❑ 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, GUTTERS AND DOWNSPOUTS ON THE HOUSE ONLY-NO STRUCTURAL
of Work CHANGES(CONTRACTOR IS HERITAGE CONSTRUCTION) **check#2586
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $6,415.00 Plan Approval $0.00 Permit Fee Paid $79.00 Park Dedication $0.00
Issued By: MP Date 04/23/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 1403690000
Cautionary Statement to Owners Obtaining Building Permits
101.65(1r)of the Wisconsin Statutes requires municipalities that enforce the Uniform Dwelling Code to provide an owner who applies for a
building permit with a statement advising the owner that:
If the owner hires a contractor to perform work under the building permit and the contractor is not bonded or insured as required under
s. 101.654(2)(a),the following consequences might occur:
(a)The Owner may be held liable for any bodily injury to or death of others or for any damage to the property of others that arises out of
the work performed under the building permit or that is caused by any negligence by the contractor that occurs in connection with the
work performed under the building permit.
(b)The Owner may not be able to collect from the contractor damages for any loss sustained by the owner because of a violation by the
contractor of the one and two family dwelling code or an ordinance enacted under sub.(1)(a),because of any bodily injury to or
death of others or damage to the property of others that arise out of the work performed under the building permit or because of any
bodily injury to or death of others of damage to the property of others that is caused by any negligence by the contractor that occurs
in connection with the work performed under the building permit.
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 sec re any necessary approval .-fore starting such activity.
I have read an• derstand the= •rementi• -d information.
Signature / Date 4/10) 1 "
Agent/Owner
Address 249 W 1 H AVE OSHKOSH WI 54902 - 6968 Telephone Number 232-0338
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
(#114
Oshkosh,WI 54903-1130
Phone:(920)236-5050 O O H fu
Fax: (920)236-5084 Of I\ I I
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
ifyou want this processed through your account ri
JOB ADDRESS 7/ I G �) / ,A-NV L
OWNER
r.
CONTRACTOR It-e 7 ' IA
I am the: 14,Owner OR ❑ Contractor
USE CATEGORY
yz Single Family ❑Duplex Cl Multi-Family ❑Rental Cl Commercial ❑Industrial
Work being done:
ROOFING
R Tear off and replace existing roofing on Zi 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 tl�Other P-P Yi7lY xt n7Yr)
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) Cl 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: E J Blocks previously installed. ❑No outside lights. ❑Other
❑Install new or Replace gutters
❑Install new or ItErReplace downspouts
Other related work being done: (please note)
Value of the job $ q I , (include fair market price for labor even if you are not paying for labor) 03/02