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Home My WebLink About0106939 BNo106939 CITY OF OSHKOSH OSHKOSHBUILDING PERMIT - APPLICATION AND RECORD ON THE WATER MARK NIELSEN Job Address1521 WELLINGTON DROwnerCreate Date03/15/2004 DesignerContractorPORTSIDE PROPERTIES INC Category110 - New Single FamilyPlanF1-020-0304R TypeBuildingSignCanopyFenceRaze R-1 ZoningClass of Const:8SizeIRR Sq. Ft.Projection Unfinished/Basement1232Rooms4Height27Ft. Finished/Living 2458Sq. Ft.Bedrooms3Stories2Canopies0 Garage780Sq. Ft.Baths3Signs0 Poured ConcreteFloating SlabPierOther Foundation Concrete BlockPostTreated Wood Occupancy PermitRequiredFlood PlainNoHeight PermitNot Required Park DedicationRequired# Dwelling Units1# Structures1 NSFR/ 2 story home with a 3 car attached garage, NO DECK OR PATIO. Use/Nature of Work HVAC ContractorMCM AIR INCPlumbing ContractorWATTERS PLUMBING Electric ContractorHARV'S ELECTRIC Fees: Valuation$151,000.00Plan Approval$75.00Permit Fee Paid$562.00Park Dedication$200.00 03/18/200400/00/0000 Issued By:DateFinal/O.P. Permit Voided Parcel Id #342710000 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. SignatureDate Agent/Owner 923 S MAIN STOSHKOSHWI549020000426-1544 Address-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. GRADE STAKE FORM OSHKOSH Grade Stake Number7119 ON THE WATER NameMARK NIELSENAddress1521 WELLINGTON DRCreate Date03/15/2004 Block Lot235Ward Subdivision5th Add to Westleigh FarmsZone Sidewalk Existing Street NumberLot Dimensions Building Grade Elevation Stakes Set At Site03/16/2004Set By D.W.G. BK - 594 , P - 19 Department of Public Works I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced. Wisconsin Department of Industry, WISCONSIN UNIFORM Application No. Labor and Human Relations BUILDING PERMIT 0106939 Safety and Buildings Division P.O. Box 2509 Parcel No. APPLICATION Madison, WI 53701-2509 Wisconsin Statues 101.63, 101.73 PERMIT REQUESTED üü ConstrHVAC ElecPlbgOther: üü Erosion Owner's NameMailing AddressTelephone No. MARK NIELSEN1521 WELLINGTON DROshkoshWI54901-0000426-1544 Contractor: üü ConElecHVACPlbg Mailing AddressTelephone No. Lic/Cert # PORTSIDE PROPERTIES INC923 S MAIN STWI0 6461 OSHKOSH54902-426-1544 Contractor:Mailing AddressTelephone No. Con üü ElecHVACPlbg Lic/Cert # HARV'S ELECTRICWI0 6909 401 MILWAUKEE STKEWAUNEE54216-(920) 388-3699 Contractor:Mailing AddressTelephone No. ConElec üü HVAC Plbg Lic/Cert # 4264 WINNECONNEWI54986920-582-4402 MCM AIR INC6122 COUNTY ROAD M-9780 Contractor:Mailing AddressTelephone No. Con ElecHVAC üü Plbg Lic/Cert # WATTERS PLUMBINGMENASHA54952-118 PO BOX 118WI920-733-8125 Lot Area PROJECT LOCATION 1/4,1/4,Section,TN,RE(or)W Sq. ft. Building AddressSubdivision NameLot No.Block No. 1521 WELLINGTON DR235 5th Add to Westleigh Farms Zoning District(s)Zoning Permit No.FrontRearLeftRight Setbacksft.ft.ft.ft. 1. PROJECT3. OCCUPANCY6. ELECTRICAL9. HVAC EQUIPMENT12. ENERGY SOURCE üü New üü Forced Air Furnace Nat.L.P.OilElec.SolidSolar üü Single Family Entrance Panel Repair Fuel Gas * Two FamilyRadiant Baseboard or Panel amp Alteration 200 Size: Raze Garage Space Htg Service: Heat Pump Addition Move Other (print):Overhead üü Water Htg Boiler üü Underground Other: üü Central Air Conditioning *Dwelling unit will have 3 kilowatt or 4. CONST. TYPE7. FOUNDATION Other more installed electric space heating equip. Concrete 2. AREA INVOLVED üü Site Constructed 10. PLUMBING Infiltration control option is:Full sealing Masonry Manufactured Unfinished Sewer of joints.Blower door test.Exterior Treated Wood Basement1232Sq. ft. air infiltration barrier. üü Municipal 5. STORIES Other 13. HEAT LOSS (Calculated) 1-Story Septic Living Area2458Sq. ft. 8. USE 39832 EnvelopeBTU/HR Permit No. üü 2-Story 780 GarageSq. ft. Seasonal 24700 InfiltrationBTU/HR Other 11. WATER üü Permanent 14. EST. BUILDING COST üü Municipal Utility Other $214,500.00 Plus BasementPrivate On-Site Well The applicant agrees to comply with all applicable codes, statues and ordinances and with the conditions of this permit, understands that the issuance of the permit creates no legal liability, express or implied, on the Department or municipality; and certifies that all the above information is accurate. APPLICANT'S SIGNATURE DATE SIGNED This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or APPROVAL CONDITIONS revocation of this permit or other penalty see standard conditions of approval State of: TownVillage üü CityCounty Municipality Number of Dwelling Location: ISSUING 7 0 - 2 6 6 City Of Oshkosh JURISDICTION PERMIT(S)WIS. UNIFORM PERMIT FEES:PERMIT ISSUED BY: ISSUEDSEAL NO. üü Construction Plan Review$75.00 Nicole Krahn Name HVAC Inspection Electrical Wis. Permit Seal$30.00 3/15/04 Plumbing Date üü Erosion Other 248101 Cert. No. 306880 $105.00 Total SBD-5823 (R. 07/92) OSHKOSH ON THE WATER .lob Address 1521 WELLINGTON DR Name MARK NIELSEN Address 1521 WELLINGTON DR Subdivision 5th Add to Westleigh Farms Building Permit Number 0106939 Number of Dwelling Units Fee Required PARKLAND DEDICATION FEE COLLECTION RECORD Date 03/18/2004 Oshkosh WI 54901 Lot 235 1 Number of Structures $200.00 Fee Paid Owner's Signature Inspector's Signature Date Date