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Home My WebLink AboutBuilding r CITY OF OSHKOSH N°- � �2� � � PERMIT - APPLICATION AND RECORD TYPE: BLDG� HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONWG �� FLOOD PLAIN `�i�� HEIGH'f�"� - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �-'� � � PLAN N0�1' I!� ' �'�C' I�_ OWNER r�. ... ��-:i ---��' c �N c� DESIGNER USE/NATURE OF WORK �(��'�J � F-'�- f�J� ��77�" �1'u � BUILDING CONi�RACTOR ��`��-- �� ' � S¢ `'.�_��'�.' �Sq. Ft.�C�° (S 77 # Rooms �� f� # Stories '�� ' �:t'/ Height �� t% Foundation ��-�-n' Class of Const 1�% Occupancy Permit �'� 6 HEATING CONTRACTOR �t-'�--U�%=�, Heat ❑ NC ❑ Vent ❑ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR � -� ' ��' ��- -� . Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits � PLUMBING CONTRACTOR �i�a- � �<�--��_ —BT —WH —Disp —WSoft —CBasin Lav —Sh -DW -DF -San. Sewer WC —FDr —SP -Ur -Storm Sewer Sink _LTub —Eject —SS —Water Other FEES: Valuation $ C% � ��' � �' ,�fnit Fee Paid $1 � Park Dedication $ ��JCJ ISSUED BY �'�-� " ^ �'L �'� �" Date � � �'�% Final/0.P. � �� In the performance of this work I agree to pertorm all work pursuant to rules governing ihe described construction. , SIGNATUR Q � /,� �� ` L' �J AGENT'OWNER �AT 1 �J ADDRESS � �� ) � _" O�S^ I! � � TELEPHONE# �, Revzsed: 8/89 • ', ZONING/LAND USE COMPLIANCE CHECKLIST I JOB LOCATION: ��l„�;: i��!F ;�F' ZONING: PROPERTY OWNER/CONTRACTOR: ;_-� ;� ;- .� ' .� t � CONSTRUCTION DATA: =�NEW CONSTRUCTION ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool , sign, deck, etc. ) 4, � � - � ,�� , � - _ - COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT DEFICIENCY/COMMENTS � Use v Lot Width ✓9 Lot Area f✓�/�f' Floodplain � Front Yard �„ %� Side Street (frart yard) ✓ Rear Yard `� Side Yard (R) � Side Yard (L) �� Parking Spaces ti Building Area _. i�- Lot Area Per Family iG� Corner Lot Landscaping Transitional Yard Off-Street Loading Vision Clearance 1� Height REVIEW AUTHORITY: li' l�G"�� lEO ( °��ez-- The Director of Cortmunity Development, or designee, must approve all plans, except the following: (1 ) Alterations or interior work when the use is conforming and when no change in use is proposed. (2) t4aintenance items; e.g. siding, windows, etc. , when the use is conforming and when no change is proposed. Instances where work complies with the above criteria, the permit can be reviewed by the Building Inspector without referral to the Director of Community Development, or designee. � APPROVED DENIED Plan Commission Action R uired Variance(s) Required \� REVIEWED BY: � � �2�% DATE: � 1� � � �l " �7710 � �G2J��_ Stateo�Wisconsin WISCONSIN UNIFORM ` � Depariment of Industry, � Labor&HumanRela[ions BUILDING PERMIT APPLICATIONNO. Division ot SaFety&Buildings Mad s9on,WI 53707 APPLICATION Wisconsin Statutes 101.fi3,101.73 See/nsfructions on back oJ ink ca PARCEL NO. � PERMIT REQUESTED ', �STRUCTURE ❑ HVAC ❑ ELEC ❑ PLUMBING Owner's Name Mailing Address Telephone � �. er 1/ � G �-- : c.: z=. 'n�� `_ Contractor's Na e Mailing Address Telephone PR0JEGT C�GATIt,�N %a. '/<,SECTION ,T N,R E or W BuildingAddress Subdivis�,N�"'e LotNo. ' BlockNo. !'�' z" r>DF" ZoningDishict � LotArea Fron2 Rear � L � Right �� Q E�f� s .n. Setbacks s e. � e. � ' e. e. 1a PR0JECT ; 9. TYpE 6. ELECTq{CAt 9r:HVACEQUtPMENT 12.lENE GYS0UqC ' ew ❑Addi[ion ❑ Raze ingle Family Entrance Pa Forced Air Furnace Fuel Nat LP. Oil Elec.Solid olar ❑Aiteration ❑Repair ❑ Move Two family Size:�amp ❑ Radiant Baseboard or Panel G � ❑O[her Service: ❑ HeatPump SpaceHtg. ❑ ❑ ❑ ❑ ❑ ❑Other . �nderground ❑ Boiler Wa[erHtg. ❑ ❑ ❑ ❑ ❑ ❑Overhead ❑ CemraiAirContlitioning lb. GARAGE ' A. C0N57.FYPE I7. F i7N6AT10N ; ❑ �ther < ❑owenm unit win nave 3 kilowatl or more i nstalletl electric space heatin9 equip. [[aChed ❑ Delached Sile conshUCle ConCrete� '�d:. PLUMBE�(t ' Infiltretion control option is:❑Full sealing ManufaclU�2d MasOnry ewer oi joints. ❑elower tloor test. ❑Exterior 2. ARF,1}, ❑ Treated Wood unicipal air infiltration barrier. ' ❑ O[her � Septic � � � easemenis�Sq.k. 5. ST'�}R�E9 73. ;HEAT L0$3 Ca(culaYed) _$ �� Permit No. . �� ,�j� �7 ❑ 1-Stor Envelope c' (%s'f'� BTU/HR Living Area � Sq.k. �p_Siory ❑ Seasonal � 17�:: �a�ER== S Infiltretion - '�Y�' BTU/HR Garage _� �7 Sq.ft. Other Permanent unicipal Utility 74..'�ESTIMATED C0ST ,_,i,;._,;� Other Private on-site Well S _5-�-'�z'<'- The applicant agrees to comply with the Wisconsin Unitorm Dwelling Code and other Municipal Ordinances and with the conditions of this permit;understands Ihat the issuance of Ihe permit creates no legal liab� ry express or implied,o Ihe Dep ent or Municipality;and certifies that all the above information is accurate. � - SIGNATURE OF APPLIC � ` ��r`'�"�` ��- �f"� onre / � � C�' CONDITIONS OF APPRO AL This permi is issue pursuant [o ihe following conditions. Failure to comply ay resul in suspension or revocationotthisper i[orotherpenalty. w� v � �p('� �Gc� �- ` {Jl 4 l% � �`(—' � �' K C Z r` 1$$IjlN�ii � ❑TOWN ❑VILLAGE ITY ❑ COUNTY MunicipalityNumberof MunicipalityNumberofDwelling ❑STATE ❑`J DEPE T Ins ction Authority Location,if different JIDRISDICTION oF: �'�L�� s �Q _� (��i --_- -- FEES: PERME�} WIS.UN�L.M�PERbIR�; PEHMI'F ISSF)m BY: '�. ��i�� Conshuc[ion { �� Plan Review . . . $ ��L-� / VAC NAME.... �� .�... . � ti.. Vl�J Inspec[ion . . . . $ ❑ Electrical Wis.PermitSeal(s) $ � ❑ Plumbing DATE � �� Other . . . . . $ ❑ Other `�// �/ � TOTAL . . $ Q �V CERT.NO �- �� SBDSB23(R.04/8l) WHITE—IssuingJurisCiction VELLOW—DILHR GREEN—Inspector PINK—Owner/Agent ��'� � DATE Z - / Z - `�O � � NAME =t_ - ;_ � U r �_�<_ri- ADDRESS �(l . -e_ . �..� LOT -7 / BLOCK '•`r1AD 5 � SUBDIV. 1��v � ��'�<<- ZONE � STREET N0. �� i-l��C- 1� �,�<�� l��cC LOT DIi�IENS�GNS SIDEWALK EXISTING YES � "JO � BUILDI�G GRADE ELEVATIONS STAKES SET AT SITE , 19 BY FEE: $ I5 .00 •ti , 1 ��1,; /� ��i �_ ��"""—`,(' �' `� , �EPART"�!tNT OF PL'�B�.IC WO' K �� : I , the undersigned, owner or agent of tne above described property agree to have lhe grade established before excavation has commenc d . ` r / � > ! . .[ / � ✓ - . _'�'„J ��'�� City of OshkoSh. 1/1%85 - PARKLAND DEDICATION FEE COLLECTION RECOR.D Address ;=---'u'�.,�: l��•f' �;. OwneNs Name ��a r-: _, c�r> �_ � r t-- , ,; , Name of Subdivision ;t;'E�.,_,� Lot # )'� Bldg. Permit # 7. '� ; j No. of Units � Fee Required `��-�- Fee Paid �:;c? _ _ U � , Owner's signat e � ��-� ��r Date -!% t <� �� /�-` �` , i Inspector s signature �� ,.r '�' Date �—.f9�it- , ;j , Parks Subdivision Improvement Accts. Rec. : 362-041 1 " // / / - / � ,' 3 � l .� � , �. � r � ' ` /. V T`� Iz o � p� r;� �1,�.� ' � �i U (� � � s.8a� h , z'a ' . > � , � � O � � a ,��, � � ��s-ya � a , � s, � 9 d�� e r� . � , � is•s� � , � ! _ _ ____- _� aa ' ' � � � f��.�, ,��.,�,�,�,��.�.-�.-�.�-,� � r ; y,_t, f �.. �� y6 � �'�.--�� ; �� y WNILE OU WERE AWAY FOR ` AM f Da� 3' /6-9a r��'� �o f1 OF �=�'f�J ; PHONE � TELEPHONED PLEASE CAL! � CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOD URGENT RE7URNED YOUR CALL SPECIAL ATTENTION � _/ G-x. �a� �o � �-; ��_ C f�� _:; ., ,�;; -� �� G � �< . SIGhED �l/�> L / _ - �/ OWNE _�� ._� . 7c �_ ��'r- ADDRESS G�'{��J G� � Gr-i�'' DATE �'i f i' 9v PERt1IT # /7�'7/ USE f f��c�%f�/ F'�-� ��+- Wo�[k co�sista of GENERAL CONTRACTOR %Zj � GL, ��`�r'� (2- MASON CONTFACTOR ZONE DATE INSP�CTIONS FOOTING , i_: � , ; � _ FD1N SLAB �� ,��1-llLlw� d�.. .,,. , SACKFILL i / n ° ` . ;_:. i�t,J� -'�-°;��'rii��- ,_ .., � Z' °�a sxxuc�ru� ,:,:.,.�.�.z �i,.;Eu—,,,�:.: n>fL.� _.. e✓�. ` � r � � ,. � l . , � " �2z� p ENERGY �� AL (�� _ — ._ --. ... TEMP OP � ... �� : � ___ .. .. _� �—