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. � � CITY OF OSHKOSH �`�'�'��'��o No 151833
OSHKOSH BUILDING PERMIT -APPLICATION AND RECOI�[�22
ON THE WATER `.�ATc
Job Address 2855 FOX TAIL LN Owner PAUL R/KRISTIN K WALKER Create Date 08/21/2012
Designer Contractor OWNER
Inspector Nicole Krahn
Category 041 -Residential Roofing Plan
Type � Building � Sign Q Canopy � Fence 0 Raze
2oning R-1 Class 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 0 Floating Slab � Pier Q Other
Q 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 FR(LATE PERMI�/TEAR OFF AND REPLACE EXISTING ROOFING ON THE HOUSE AND ATTACHED GARAGE,NO
of Work TRUCTURAL CHANGES (WORK DONE BY BADGERLAND RESTORATION) �check#8450
HVAC Contrector Plumbing Contractor
Electric Contractor
Fees: Valuati n $9,300. Plan Approval $0.00 Permit Fee Paid $88.00 Park Dedication $0.00
Issued By: 5��� Date 08/21/2012 Final/O.P. 00/00/0000
❑ Permit Voided� Parcel Id# 1331990000
Cautionarv Statement 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
woric 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 woric 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 pe ' ' tion within an ement,the City strongly urges the permit applicant to contact the easement
holder(s)and to cur ny ssa app als before starting such activity.
I have read a un rst the afo me ' i ation.
Signature Date � � � �
AgenUOwner
Address 2855 FOX TAIL LN OSHKOSH WI 54904 - 8963 Telephone Number
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Pertnit 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 Box1130 �
Oshkosh,WI 54903-1130
Phone:(920)236-5050 O.IHKO.IH
Fax:(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 narticioatinQ in the Permit fee Account Svstem and have adeauate funds check here
irvou want this Drocessed through vour account n
JOB ADDRESS % ) � ' � � � �
OWNER �,. t �
CONTRACTOR �
I am the: �Owner OR ❑ Contractor :
U,,SE CATEGORY
�1 Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Work being done:
ROOFING
ear off and replace existing roofing on,�hous�age
❑Replace wood decking
❑Add 1 layer of roofing to the existing layer(s)on❑house,�garage
This work is being done due t�ail 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 Electric Contractor)
AND ❑Electric Installation Verifica[ion form is attached OR ❑Sepazate Elect Permit will be requested.
2) ❑Electric—Not Applicable because: �'J Blocks previously installed. G No outside lights. C Other
❑Install new oy�R place gutters
❑Install new o�place downspouts :
Other related work being done: (please note)
Value of the job_ /����� (include fair market price for labor even if you are not paying for labor) 03/02