HomeMy WebLinkAbout0104745-Building (siding/windows)City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903ol 130
Phone: (920) 236-5050
Fax: (920) 236-5084
Roofing & Siding Permit Application
O/HKO/H
· 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 you are a contractor participatin~ in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account ~
JOB ADDRESS
OWNER
CONTRACTOR '~f ~- iq t~,~'~ HCS;rF1 ~_ '~ ~ g/~O ~J ~'~').[5,"'-1 "i'-,~
I am the: [~Owner OR ~Contractor
SE CATEGORY
iugle Family [] Duplex [] Multi-Family
[]Rental D Commercial []Industrial
Work being done:
ROOFING
[] Tear offand replace existing roofing on [] house, [] garage
[] Replace wood decking
[] Add 1 layer of roofing to the existing
This work is being done duc to [] Hail Damage [] Other
SIDING
J~Instatl sidingon ~house, [] garage
[] Replacing vinyl with vinyl
~l~ Replacin~r al. uminum with vinyl (circle steel or aluminum)
[] Replacing with
This work is being done due to [] Hail Damage [] Other
layer(s) on [] house, [] garage
When siding is done, one of the boxes below must be checked:
1) X Etectric - Existing Electric Meter, receptacle, lighting and Electric Service entrance alterati°ns/m°dificati°ns arc being perf°rmed
'by
(Name of Licensed Electric Contractor)
ANE~/Electric Installation Verification f~rm is attached O...~R [2 Sel~arate Elect Permit wffi be requested.
2) [] Electric - Not Applicable because: [2 J Blocks previously installed. [2 No outside lights. [] Other
[] Install new or .~ Replace gutters
[] Install new or ~1 Replace downspouts
Other related work being done:
Value of the job $ ~00 ~ (include fair market price for labor even if you are not paying for labor) 03/02
O-7'HKO/H
City of Oshkosh
Division-o f~nspection Serv/ees
215 Church Avenue
POBox 1130
Oshkosh W1 54903-1130
Office 920-236-5050
Fax 920-236-5084
I (We)
the homeowner(s) of
Electric Installation Verification
tfi ,tint ~o'~ner(3 name~
(address where work is trr~oe performed)
accept the responsibility for performing the electrical work as stated below for the property listed
above.
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures,
New circuit for the addition of A/C to an individual dwelling unit, including
required service electrical outlets. Note: Homeowners can only do their own
electric on a single family owner occupied home. l~ork on a condominium.
duplex, rental, or multi-use building would require a licensed maxter
electn'cian.
Other
The value of this work is $ / r) D, ~
I hereby verify this work will be performed by me and further verify the reconnection /
installation will5e done in compliance with manufacturer and Electric code requirements.
omeown6r(s) Signature
(Date)
5/02