HomeMy WebLinkAbout0155785-Building (roof) '�,! CITY OF OSHKOSH No 155785
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 830 CONCORDIA AVE Owner SHAWN P/LISA BREWER Create Date 05/23/2013
Designer Contractor OWNER
Inspector Nicole Krahn
Category 041 -Residential Roofing Plan
Type � Building � Sign � Canopy � Fence � Raze
Zoning R-1 Class of Const: Size
Unfinished/Basement
Sq.Ft. Rooms Height Ft. � Projection �
Finished/Living Sq.Ft. Bedrooms Stories Canopies
Gara9e Sq.Ft. Baths Signs
Foundation � Poured Concrete � Floating Siab � Pier � Other
� Concrete Block 0 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 FR/Tear off and replace existing roofing on house only. No structural changes.
of Work
I
HVAC Contractor Plumbing Contractor I
Electric Contractor
Fees: Valuation $4,500.00 Plan Approval $0.00 Permit Fee Paid $65.00 Park Dedication $0.00
Issued By: Date 05/23/2013 Final/O.P. 00/00/0000
❑ Permit Voided I Parcel Id# 1310320000
Cautionarv Statement to Owners Obtaininq Buildinp Permits :
101.65(1 r)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 pertormance 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 approvals before starting such activity.
I have read and un rstand the aforementioned information.
Signature Date �J ��
AgenUOwner
Address 830 CONCORDIA AVE OSHKOSH WI 54902 - 6341 Telephone Number
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 OfHKO.IH
Fax:(920)236-5084
ON THE WATER �
Roofing & Siding Permit Application :
• 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
�vou are a contractor participating in the Permit fee Account Svstem and have adepuate funds check here
if vou want this processed through vour account n
JOB ADDRESS �� O � 0'1�����j� �� l�C�i
OV1'NER t�+'l-Ci fn-�'C I�) ��w �
CONTRACT
-- 1 ' �
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I am the: ��Owner OR ❑ Contractor
�
E CATEGORY
Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Work being done:
ROOFING
�ar off and replace existing roofing o�ouse,❑garage
v
❑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 Elechic Contractor)
AND ❑Electric Installation Verification form is attached OR �Separate Elect Permit will be requested.
2) ❑Electric—Not Applicable because: ❑J Blocks previously installed. C No outside lights. G Other
❑Install new or 0 Replace gutters
❑Install new or❑Replace downspouts
Other related work being done: (please note)
Value of the job $ C� (include fair market price for labor even ifyou are not paying for labor) 03/02