HomeMy WebLinkAbout0158349-Building (roof) � CITY OF OSHKOSH No 158349
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OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 43 LAKE ST Owner DAVID M BARLOW/DANIELLE J DORMAN Create Date 10/18/2013
Designer Contractor OWNER
, Inspector Andrew Prickett
Category 041 -Residential Roofing Plan
Type � Building � Sign � Canopy � Fence � Raze I
Zoning R-2 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 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 house. No structural changes. ,
of Work
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HVAC Contractor _ Plumbing Contractor
Electric Contractor
Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid $51.00 Park Dedication $0.00
Issued By: Date 10/18/2013 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id#0803560000
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 erstand the afoIrf mentioned in ormati n. �,�
Signature � C j�Z,{ti,,Y �-��� Date lU ` ��' '�
a
AgenUOwner
Address _ _ _Oshkosh WI 54901 - 0000 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 Q1HK0� '
Fax:(920)236-5084 �
Roofing & Siding Permit Application °N�"��,A�FR
• Application(s)and fee(s)can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1 1 28. Commencing wark 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 Pernait �ee Account Svstem and have adeguate funds check here
if vou want this processed throu�h vour account n
JOB ADDRESS �� v�'�'�� S�
OWNER C.l.l T-P �i (�✓ I l�W ��C,LU1 I� �� ��d�M-C��
CONTRACTOR �
I am the: ��Owner OR ❑ Contractor
USE CATEGORY �
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
:
Work being done:
ROOFING
�d Tear off and replace existing roofing on�house,❑garage ' �
❑Replace wood decking
❑Add 1 layer of roofing to the existing layer(s)on❑house, ❑garage
This work is being done due to O Hail Damage ❑Other
SIDING
❑Install siding on ❑house, ❑garage
0 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) ❑Electrfc—Eacisting Electric Meter,receptacle,lighting and Electric Service entrance alterations/modificaTians are being performed
by
(Name of Licensed Electric ConVactor)
AND ❑Electric Installation Verification form is attached OR =Sepazate Elect Permit will be requested.
2) ❑Electric—Not Applicable because: ��J Blocks previously installed. J No outside lights. ��Other
❑Install new or❑Replace gutters
❑Install new or❑Replace downspouts
Other related work being done: (please note)
� �5��+bu�
Value of the job $��OOO . �� (include fair market price for labor even if you are not paying for labor) 03/02
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