HomeMy WebLinkAbout0155671-Building (roof) � CITY OF OSHKOSH No 155671
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OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1926 MICHIGAN ST Owner MICHAEL CZLAPINSKI/NANCY K ROLFS Create Date 05/16/2013
Designer Contractor PACKER VALLEY BUILDERS, INC
Inspector Nicole Krahn
Category 041 -Residential Roofing Plan
Type � Building 0 Sign � Canopy � Fence � Raze I
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 � Poured Concrete � Floating Slab 0 Pier � 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 &SIDING ON THE HOUSE ONLY-NO STRUCTURAL CHANGES "check
of Work 34696
i
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $11,500.00 Plan Approval $0.00 Permit Fee Paid $112.00 Park Dedication $0.00
Issued By: �� Date 05/16/2013 Final/O.P. 00/00/0000
�r• ❑ Permit Voided I Parcel Id# 1409820000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any ne s ry appr als before starting such activity.
I have read and�ndersta nre m ioned information.
Signature Date
AgenUOwner
Address 227 CLAIRVILLE ROAD OSHKOSH WI 54904 - 0000 Telephone Number 920-232-7620
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
13-05-15 18:49 Packer Valley/Nekimi 920 232 7622 » P 1/1
� C�l �f�S1L�QSh � � P O Box t 130
J , Oshkosh,W1549p3•Il30
� � •- . .. .. Phone;(920)236-SOSO
Fax:(920)236-5084
� � Bui�ding Permuit Applicatxon �•cLos6kosh.w�us
Projcct ' �
Address fC/p7� �% (�i I (/�F� �� �
ApP��o� Owner ontract r Tcn�nt Othcr(describe) `
Owner/ �
'r'cnant Name � ` � � ��O�r
Phonc
, Address � ' ��d— � �
• Email
Contrnctor Company Name 6►^ r�
�„� � � �1'S Phonc_��1�p?.��v�� .
Concact
, Email
Addross 7� r l di — C/$ �zS . .1^ cl7 '-1'�f�
State Crodential#'s J�� Qlp : .
Dwclting Controctor- Qua`li�erf i{ ' Dw�lling Contractor# ' �uildin Conttnctor
B Rtgistration#
Achitcct/ Company Name
Dcsigncr Phonc
Contact Email
Address �
Permit Ty Residential Singlc Famil Itesidcntial Daplex Commercial Multifamily Industris!
Catagory New Additioe Alteration
Project
pcscription
� � �n Q i i
Mcch�nicnl. Sept►ratc permits wili be obtsined for the following;
Pcrmits Electrical b
Y Plumbins by Heating by
Value olJob $
• (Value for materials 8t labor i,rrq,to ensure coruistenCy in aceeSSing permit f�cs for at!uyp�ipals,)
Paymcnt by; Check # 3�((p�(r� Cash Permit�ce Aeeount
��
/ecy{fv thc obove lnjornrallon is comp/c/c and occuiora .1ny devinrlo�,sJrom the above submi��ed injo�matron may require addldo��lpermiir
lo be oblained a n /cd d ogre io�hese lrrms,
N�mc: �,!. �7 (Plc�so print) Date:_S -l`J� "�,�
Signatura: