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Home My WebLink About0156921-Building (roof) '�,� CITY OF OSHKOSH No 156921 OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 424 MERRITT AVE Owner COREY M DOMKE Create Date 07/26/2013 Designer Contractor OWNER Inspector John Zarate Category 041 -Residential Roofing Plan Type � Building � Sign � Canopy � Fence � Raze Zoning R-2PD Class of Const: Size Unfinished/Basement Sq.Ft. Rooms Height Ft. � Projection I Finished/Living Sq.Ft. Bedrooms Stories _ Canopies Garage Sq.Ft. Baths Signs Foundation � Poured Concrete � Floating Slab � Pier � Other � Concrete Block � Post � Treated Wood Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit Park Dedication #Dwelling Units 0 #Structures 0 Use/Nature SFR/Re-roofing*to include tear off and replacement of shingles. No structural work. Any Lead issues shall be resolved prior to starting of Work he work.Owner has signed affidavit that he will reside in the home. , � � HVAC Contractor _ Plumbing Contractor Electric Contractor Fees: Valuation $2,500.00 Plan Approval _ $0.00 Permit Fee Paid $51.00 Park Dedication $0.00 ' Issued By: Date 07/26/2013 Final/O.P. 00l00/0000 ❑ Permit Voided I Parcel Id#0404430000 Cautionarv Statem nt to Owners Obtaininq Buildinq 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 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 appr before starting such activity. I have read and under _ the aforem ion i ormation. Signature Date AgenUOwner Address 238 W STH AVE OSHKOSH WI 54902 - 5926 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 specifed 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 Osl�kosh � Inspection Services Division P O Box 1130 � � Oshkosh,WI 54903-1130 Phone:(920)236-5050 01HKOfH F�:(920)236-5084 � Roofing & Siding Permit Application �N THE WATFR • 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 vou are a contractor participating in the Permit fee Account Svstem and have adequate funds check here � i£vou want this processed throu�vour account n JOB ADDRESS �� \ Y��r�� (��-� O�'1'NER�� -.�� o'M�� CONTRACTOR I am the: C�Owner OR ❑ Contractor �(SE CATEGORY �j Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial Work being done: ROOFING �Tear off and replace existing roofing on❑house,�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 b/c� fl«� C'rp(c�cr.v.0� SIDING ❑Install siding on ❑house, ❑garage ❑Replacing vinyl with vinyl ❑Replacing steef or alwninum 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 Elecuic Contractor) AND ❑Electric Installation Verification form is attached OR C Separate Elect Permit will be requested. 2) ❑Electric—Not Applicable because: �J Blocks previously installed. C No outside lights. ❑Other ❑Install new or❑Replace gutters ❑Install new or O Replace downspouts Other related work being done: (please note) Value of the job $ o� S�� (include fair market price for labor even if you are not paying for labor) 03/02 �/.�- 1 IS t :