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Home My WebLink About0103827-Building 1:14) CITY OF OSHKOSH No 103827 C,AN`` OSHKOSH -' BUILDING PERMIT - APPLICATION AND RECORD 1T ' ON THE WATER ° ATE Job Address 1834 MICHIGAN ST Owner ADAM R GEURTS Create Date 08/20/2003 Designer Contractor SUPERIOR BUILDERS Category 110 - New Single Family Plan E1- 119 -0308R Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze Zoning R -1 Class of Const: 8 Size Irrg Unfinished /Basement 76 Sq. Ft. Rooms 6 Height 21 Ft. ] Projection Finished /Living 1770 Sq. Ft. Bedrooms 3 Stories Bi -level Canopies 0 Garage 540 Sq. Ft. Baths 2 Signs 0 Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other Concrete Block 0 Post O Treated Wood Occupancy Permit Required Flood Plain No Height Permit Not Required Park Dedication Required # Dwelling Units 1 # Structures 1 Use /Nature NSFR/ New single family, 2 car attached garage and 12' x 12' deck. Driveway shall not exceed 24' wide at the front property line. of Work HVAC Contractor MCM AIR INC Plumbing Contractor HANSON QUALITY PLUMBING Electric Contractor SCHOMMER ELECTRICAL CON Fees: Valuation $100,000.00 Plan Approval $75.00 Permit Fee Paid $380.00 Park Dedication $100.00 N i Issued By: ice +ti \- Date 08/29/2003 Final /O.P. 00 /00 /0000 ❑ Permit Voided 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.. necessary approvals before starting such activity. Signature `! ,1,„'f,,,;j Date X ',2/-465 Agent/Owner Address 735 FOXFIRE DR Oshkosh WI 54904 - 0000 Telephone Number 920 - 232 -6777 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. 0 SGAiyN OSHKOSI GRADE STAKE FORM XI/4 ON THE WATER Grade Stake Number 7020 S ATE Name ADAM R GEURTS Address 1834 MICHIGAN ST Create Date 08/20/2003 Lot 71 Block Ward Subdivision Smith Grove Land Cos Replat Zone Street Number Lot Dimensions J Sidewalk Existing Building Grade Elevation Stakes Set At Site 08/20/2003 Set By Department of Public Works 1, the undersigned, owner or agent of the above described property agree to have the grad- established before excavation has commenced. Wisconsin Department of Industry, WISCONSIN UNIFORM Application No. Labor and Human Relations and Buildings Division BUILDING PERMIT 0103827 `� 1 P.O. Box 2509 APPLICATION Parcel No. Madison, WI 53701 -2509 Wisconsin Statues 101.63, 101.73 0, PERMIT REQUESTED 0 Constr ❑ HVAC ❑ Elec ❑ Plbg 0 Erosion ❑ Other: Owner's Name Mailing Address Telephone No. ADAM R GEURTS 735 FOX FIRE DR OSHKOSH WI 54904 - 6590 685 -6899 Contractor: 0 Con Elect HVAC IA Plbg Lic /Cert # Mailing Address Telephone No. SUPERIOR BUILDERS 831271 735 FOXFIRE DR Oshkosh WI 54904 - 0 920 - 232 -6777 Contractor: H Con U Elec U HVAC❑ Plbg Lic /Cert # Mailing Address Telephone No. SCHOMMER ELECTRICAL CON 170465 N 164 TWO MILE RD APPLETON WI 54914 - 9121 (920) 731 -2299 Contractor: H Con J Elecu HVAC J Plbg Lic /Cert # Mailing Address Telephone No. MCM AIR INC 4264 6122 COUNTY ROAD M WI NNECONNI WI 54986 -9780 (920) 582 -4402 Contractor: J Con J Elec ❑ HVAC J Plbg Lic /Cert # Mailing Address Telephone No. HANSON QUALITY PLUMBING 550 N BLUEMOUND RD APPLETON WI 54914 -0 730 -0205 ; PROJECT LOCATION Lot Area � Sq. ft. 1/4, 1 /4,Section ,T N,R E(or)W Building Address Subdivision Name Lot No. Block No. 1834 MICHIGAN ST Smith Grove Land Cos Replat 71 Zoning District(s) Zoning Permit No. Front Rear Left Right - .. , ,1. PROJECT Sierienr41 '000UPANCY ,6. ELECTRICAL (.9. HVAC:. EQUIPMENT''` X12. ENERGY SOURCE ' 0 New El Repair 0 Single Family Entrance Panel 0 Forced Air Furnace Nat.ffil Oil Elec. Solid Sola El Alteration — Two Family Size: 200 am. El Radiant Baseboard or Panel Fuel Ga ❑ Raze ❑ Addition Garage Service: ❑ Heat Pump Space Ht 121 ❑ ❑ ❑ ❑ ❑ ❑ Move ❑ Other (print): ❑ Overhead Water Ht 0 ❑ ❑ ❑ ❑ ❑ [� Undergrou ❑ Boiler ❑ Other: 4.''CONST TYPE - VT. FOUNDATION ❑ Central Air Conditioning * U Dwelling unit will have 3 kilowatt or • Other„ more installed electric space heating equip. .2. AREA INVOLVED ozer2,ta 0 Site Constructed • Concrete x'10. PLUMBING * Infiltration control option is: ❑ Full sealing g Unfinished ❑ Manufactured ❑ masonry Sewer of' r ❑ Treated Wood joints. ❑ Blower door test. ❑ Exterior Basement 76 Sq. ft. ;5. STORIES 0 Municipal air infiltration barrier. 1-Story ❑ Other ... Living Area 1770 Sq. ft. ry ❑ Septic Ki�•1�- �ia� ®F.� alculated 2-Story ,«;8 �, Garage 540 S ft, ❑ ry Permit No. Envelope 17270 BTU /HR q• ❑ Seasonal BTU /HR ❑ Other F ,11. 11. WATER Infiltration 1 1775 Bi -level 0 Permanent 0 Municipal Utility 44. EST. BUILDING COST r� ❑ Plus Basement ❑ Other P rivate On -Site Well ❑ $115,000.00 The applicant agrees to comply with all applicable codes, statues and ordinances and with the conditions of this permit, understands that the issuance of the permit creates no legal liability, exp =ss e im i -d, on th ep ment or mu ' pality; and certifies that all the above information is accurate. APPLICANT'S SIGNATUR DATE SIGNED g -....:2 - 6....� APPROVAL CONDITIONS r - is permit is issued ` pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty SEE "STANDARD CONDITIONS OF APPROVAL" SHEET ** ** * * * ** Town Village !I SSUING ❑ T ❑ 9 Q City ❑ County ❑ State of: Municipality Number of Dwelling Location: JURISDICTION City Of Oshkosh 7 0 - 2 6 6 r+, ` rr •r• . . . �+r ♦ w 44. .w+r .•,, . . , .,... , . owy 0,0,e' , , *""**s"' o * *r#r i"r� *,"' *"" ° w• " � *oa " * " * * w *i " i* rao,x 'FEES PERMIT(S) „ WIS UNIFOR PERMIT „ �.o o *, * '� x� : , **„ ,t *$• „ ,e K •,PERMIT ISSUED BY' a�' ,,,�** ” * * * *.�' * �+ a I SUED SEAL 14C . fix �'' ". .' a Plan Review $75.00 Q Construction Inspection HVAC Name JOHN ZARATE Electrical Wis. Permit Seal $30.00 I 1 Plumbing Date 8/22/03 Other ✓ Erosion Total $105.00 ❑ 292172 Cert. No. 70330 SBD -5823 (R. 07/92) 0 6CA%Vti OSHKOSH PARKLAND DEDICATION FEE COLLECTION RECORD o'>> „ PARK ° ON THE WATER 0 Job Address 1834 MICHIGAN ST Date 08/29/2003 Name ADAM R GEURTS Address 735 FOX FIRE DR OSHKOSH WI 54904 Subdivision Smith Grove Land Cos Replat Lot 71 Building Permit Number 0103827 Number of Dwelling Units 1 Number of Structures 1 Fee Required $100.00 Fee Paid Owner's Signature �i / 1A Date X2;2 Inspector's Signature `�' 0.— Date / 6010 C, q C S ,2 % —* A‹ ( ( = , pnOv,, •.■ S &Po an el?). Y %. 0 . / 1 f / 1 ' JUNLINfir : P e K ((ulu/et) „ _