HomeMy WebLinkAbout0155672-Building (roof) � CITY OF OSHKOSH No 155672
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OSHKOSH BUILDING PERMIT -APPUCATION AND RECORD
ON THE WATER
Job Address 2428 BLAKE CT Owner PAULA/LORI A KUBICEK Create Date 05/16/2013
Designer Contractor PACKER VALLEY BUILDERS, INC
Inspector Nicole Krahn
Category 041 -Residential Roofing Plan
Type � Building � 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 � Floating Slab � Pier � Other '
� Concrete Block Q 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 ON THE HOUSE AND ATTACHED GARAGE-NO STRUCTURAL CHANGES
of Work check#34696
L
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $12,000.00 Plan Approval $0.00 Permit Fee Paid $112.00 Park Dedication $0.00
Issued By:C"_L 1_1� Date 05/16/2013 Final/O.P. 00/00/0000
`• ❑ Permit Voided i Parcel Id#0622080100
In the perFormance of this work I agree to perform ali work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perForm the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure a necessa pprovals before starting such activity.
I have read and unde e af inentioned information.
Signature Date J /�j /
AgenUOwner
Address 77 CLAIRVILLE ROAD OSHKOSH WI 54904 - 0000 Telephone Number 920-232-7620
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
13-05-16 06:25 Packer Valley/Nekimi 920 232 7622 » P 1/1
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I��Oi OS11aOS� ; ,. ., � � � ' � Oshkosh�WT 54903.1130
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. ,. ... _ .. . on�:(920)236-SOSO
Fax:(920)?36-5084
� : . Bui�ding Perm�it A�plicatYOn '"'`y"'•a°�k°S�."'�u$ :
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Projcct '
Address �. �� �0.��- � �I'� <�. .� . . • .
Applicaat Owner � Contracto . .Tcnant pthcr(dcscribe) � :
Owacr/ N�c t�
1f cnaat � Phonc � 1 � 2 D 9/
� Address 2� S�s C r st- C-�. s�ikosl� �ma�i - . ...—
Contwrctor Company Name C�,C �L� � t,r. � Phone �32- 7�0 20
Conwct O �_eC`5 �mail
Address 22�'� ��G�Y' Ut ,12 Ut��f
Stace Crodential #'s r _�p � ,�
Dwelling Contr�fccor Quolificr# Dwellit�g Contr�ctor�/ � Building Coatrnctor RcgisaaGoa!l
Achiecct/ Company Name '
Desigacr Phone :
Contsct ����
Address '
Permit Typ� Residential 5ingle Family �R�sidential Duplex Commctcial Multifamily Industrial
Catagory New AddiAOn Altecation
Project
Dcscription
c�. �c O��
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Mcchanitat_ Sepsrate permits will bc obtained for the following:
pc��� Electrical b
Y Plumbing bY Hcating by
Value otJob $ �2 DO�' �'�
(Valuo for matcrials�labor is rsq.co rnavrc consistCn�y in acccssing permit fces for all apDlicants•)
Payment by: Chtck # 3��y1( Cash Permit�ee Account
/ccrilfy�lrc abovc info�niar/on!s.complere nnd pccurnle. Anv dcvia�ions jiom�lie above submined informollon moy rcqulrc addiliono!permlls
ro bc obroincd /acknowlc�`nd pbict lo�hcsc I�rniS,
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Name: �/10►'�1�► ( i er,S (Plcasc print) Date:�— �3
Signaturc• . ,<v :