HomeMy WebLinkAbout0156889-Building (roof) /� CITY OF OSHKOSH No 156889
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER -
Job Address 121 W 21 ST AVE Owner JEAN KELLERMANN Create Date 07/25/2013
Designer Contractor HICKEY ROOFING
Inspector John Zarate
Category 041 -Residential Roofing Plan
Type � Building � Sign � Canopy _ � Fence 0 Raze �
Zoning R-2 Ciass 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 � Post � Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature 'SFR/tear off and re-roof house and garage
of Work :
*"debit acct**
HVAC Contractor Plumbing Contrector
Electric Contractor
Fees: Valuation $8,798.00 Plan Approval $0.00 Permit Fee Paid $93.00 Park Dedication $0.00
Issued By: s� Date 07/25/2013 Finai/O.P. 00/00/0000
❑ Permit Voided i Parcel Id# 1400600000
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 approvals before starting such activity.
I have read and understand the afore mentioned information.
Signature Date
AgenUOwner
Address 1427 BROAD ST OSHKOSH WI 54901 - 3047 Telephone Number (920)426-4008
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.
I 2413 01:14p Hickey Roofing Inc 920-232-0354 p.1
- ����`� :
Cit��of Oshkosh �
Inspection Services Division �
P O Box 1130 �
Oshkosh,WT 5�903-I 130
Phone:(920)236-5050
Fax:(920)236-5084 O K H
Roofing � Siding Permit Application °�T"F��TFR
• Application(s)and feels)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,
dsh�cosh OVl �4903-1128. Commencing work without permit(s)wiIl result in fees being doubled or�100.00 plus the
normal permit fee,which ever is greater.
OR
I •ou are a contractor artici atin in the Permit e Accoun[ S stem and have ade uate unds check here
i ou ►r•ani this rocessed throu h •our accoun!
�v,r^R ADDRESS �C./ �� _
OWNER .��� ,��C.�^
CO.VTRACTOR
_._.._ ._ _ __.. .._..__...._ . _._ . _.._. ._... _ ._.._. _......--------.. ___ _-- - ----.... ...._...
v_ _.._... ___
I am the: ❑ Owner OR �Contractor
�E CATEGORY
Si�1e Family ❑Duplex O Multi-Family �Rental �Commcrcial �lndustrial
R'ork bei�sg done:
ROOFING
�£J Tear off and replacc existing roofing oryO house�J garage
/�Replacc wood deckmg �
O Add l layer of roofmg co the existing iayer(s)on 0 house,�garage
'Chis work is being done due to CI Hai(Damage ❑Other
SIDING
❑Ir�siall siding on ❑house, 0 garaee
❑Replacing vinyl with vi��l
❑Replacing stcel or aluminum«�ith vinyl(circle steel or alummum)
❑Replacing ��
This�vork is bein�done due to O Hail Damage ❑Other
When siding is done, one of the bozes below must be checked:
1) Q Electric—Existing Electric Meter,roceptacle,lightino and Electric 5ervice entrance alterations/modificazions are bein�perfortned
bv
(Name of[.ica�sad ElecuicConcraaor)
A3Y �Electric InstalEation Verification form is attached OR C.]Separate Elect Permit will be requested.
Z) ❑Electric—Not Appiicable because: U J Blocks previously installed J�10 outside lights. ❑Other
❑install riew or O Replace gutters
❑Jnstall new or O Repiace downspouts
Other related work being done: (please note)
�i 7 �
V alue of the job $ o / ��J� (inetude fair market price for labor even if you are not pa��ing for labor) 03/02