HomeMy WebLinkAbout0158890-Building (roof) � CITY OF OSHKOSH No �5ssso '
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1529 JEFFERSON ST Owner JASON J PEERENBOOM _ Create Date 11/22/2013
Designer Contractor ENVISION BUILDING
Inspector Andrew Prickett
Category 041 -Residential Roofing Plan
Type � Building � Sign � Canopy � Fence 0 Raze �
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 Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature SFR\Replace roofing-tear off and install - - -
of Work
I
,
,
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 11/22/2013 Final/O.P. 00/00/0000
❑ PermitVoided Parcelld# 1505490000
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 re a understand the afore mentioned information.
Signatur Date
AgenUOwner
Address 5374 WHITE CAP CT OMRO WI 54963 - 8240 Telephone Number 920-740-0908
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 54903-1 1 30
Phone:(920)236-5050 Of HKO.IH
F�:(920)236-5084 �
ON 7HE 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
If vou are a contractor narticinatinQ in the Permit fee .Account System and have adeauate funds check here
if vou want this processed throu�h vour account I—I
JOB ADDRESS /��"I Vi'�(�/5 Dlil ,S�
OR'NER i �<rJ� �(/P �{;vt�7
CONTRACTOR G`1L/ /ov�
I am the: ❑ Owner �Contractor
USE CATEGORY
,�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Work being done:
ROOFING
�I Tear off and replace existing roofing on�I house,❑garage
❑Replace wood decking
❑Add 1 layer of roofing to the existing layer(s)on�house,0 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 ar�d Electric Service entrance alterations/modifications aze being performed
by
(Na��e of Licensed ElecUic 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. ❑Other
❑Install new or❑Replace gutters
❑Install new or 0 Replace downspouts
Other related work being done: (please note)
Value of the ob $ d+S 0�. °`'
J (include fair mazket price for labor even if you are not paying for labor) 03/02