HomeMy WebLinkAbout0006469-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION' AND RECOR
N2
06469
ADDRESS
NO,P?~ rJ -?8'''7!C..
OWNER
DESIGNER
USE/NATURE OF WORK
~ 3f=
# Room
# Stories
Class of Const. r-
Height ~ (
Occup : cy Permit -e.~ ~
BUILDING CONTRACTOR
. 0
size)r~f Sq. Ft. ~ 'r;. L
Foundation p~ J)~
HEATING CONTRACTOR
Heat D NC D Vent D Fuel/System
Heat Loss
B U'S
1\
ELECTRIC CONTRACTOR
.;-~Iectric Servo
Fixtures
New D Change D Temp D
Type _ Volts _ Amps_
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _San. Sewe,
_WC _FOr _SP _Ur _ Storm Sew r
_Sink _ L Tub _ Eject _SS _ Water
Other
/C<0 ..oD
,. "
1~-?-2?7
Park Dedi ation $ /'0 e-J
9-
FEES: Valuation $
ISSUED BY
Final/O.P.
A
to perf L m all work pursuant to rules governing the described c: nstruction.
i/?~
DATE
TELEPHONE #
ADDRESS
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~UILDiNG CONTRACTOR .
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State of Wisconsin
Department of Industry,
Labor & Human Relations
Division of Safety & Buildings
Box 7969
Madison, WI 53707
Wisconsin Statutes 101.63, 101.73
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
(See Instructions on back of Dink coovJ
:::::::':!!: ~TRUCTURE D HVAC
Mailing AddressJ --:, II
~ 7~-o /:.. 91'1' 1 A_ _0' lGdl
Mailing Address
APPLI A TION NO.
PARC L NO.
'1~9~~:i~IIIIIIII,!!
D
ELEC D PLUMBING
Telep one
L7:r1 -f-3" ~
Telept one
Own~r's N'Y"ge , () ... '7-> Ii
G-"'v. JI.Jp~'~ I~. L I JI
Contractor's Name
(!) W '^- <2. ;-
....................... . .. ......... .. ............................ ......."...........................
.................. ..................................... ........... ....................,.
.............................. .. .................
1l11J.:illlil(>Ai't"O":)"
......................................... ...".................
............................................................
......................................... ............... .
........... ...........................
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EiorlW
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Building Addre~ 1 J I r\..l.-
/9io ~pC-.p ~ d - -:HA. LT
zoning1ZiC\ Lot 9~ :'')?? Sa. ft.
1i;~A()aEcm:~"~:I..~~1ttie$I
~ew 0 Addition 0 Raze 0 Single Family
trAlteration 0 Repair 0 Move 0 Two family
o Other
atillached
o Detached
Entrance P~
Size: I ~
~~:
~nderground
o Overhead
::I:} ......j;:gqNH~~I;fO.MNP.,4[~Q"r
~e constructed ~oncrete
o Manufactured lITMasonry
o Treated Wood
Sq. ft.$.~$1..'$$ ..... 0 Other
" 0 D' elli Ill. unit will have 3 kilowatt or
more i stalled electric space heating equip.
Infiltra on control option is: 0 Full sealing
of join 0 Blower door test. 0 Exterior
air infil' ration barrier.
DOther
'" .
1b'i GARAGE i
........................................
............... ....................
Basements
9'~2.
C'j'tpZ
;/~O
Sq. ft.
Garage
Sq. ft.
o 1-Story
~-Story
I_Other I
rJ,' I~f)'f
L.D S~sonal
~rmanent
o Other
Living Area
}';?Ph ,-
,
~_k CAJ)/
A (( r
1-.
Plan Review $
Inspection $
Wis. Permit Seal(s) $
Other $
TOTAL $
SBD 5823 (R. 04/87)
-;<[0
o VILLAGE ~TY 0 COUNTY Municipality Number of
o IND9PEtJDENT r Inspection Authority
O~~~..:s~ "2 O-~~k
...,.' ...,....,. .-"-.'"'' ,..,.
...:~'\'f~~(.. \YlS;~=:=~~~U1....P~ijM!t~~~Mi~y~:I).//'.....
~nstruction
D HV AC
D Electrical
D Plumbing
D Other
Muni ipality Number of Dwelling
Loca ion, if different
.,..........................
..............................
ISSUINI.......:.."... 0 TOWN
alRlsoltiliaN: 0 STATE
".""""""""""""",,"","',,...' ........... OF:
"--
NAME
JJ[~,.A })lT~ n- 'n ~
I / d .- >,,- R/
-r~TA/r
3,0
70
DATE
SR- 1l "7
CERT. NO.
WHITE -Issuing Jurisdiction
~OOO
YELLOW - DILHR
GREEN -Inspector
PINK - Owner/Agent
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zam1G/~m L'SE cQr.1PLIMICE CEEC!<LIST
I'. ~ ~ 21( ;?f ~L- ~o r:-o~ ~
Buildi.ng Pemit t Zo~ /- ~/ COnfoIIni.n;_
Job Iocation I" !( <eJ..~A>rh1/:. . C!fl- Lo~ Dinension
Property Owner G-u jJ A()/.J-. Y4 ~U ~ Lot: Jm!a' .
II. ' CCNS'l'lU:'l'ICN DATA
Describe i'brk:
nfoming_"
NEW CCNSTRUCl'ION
ADOITICN-
:S.iL 6C,_ '
_ Accesso~ Bui.ldi.nq
Fence
Boathouse
_ Utility Sb:1.1ctut:e
_ Other (specify) ,
III. ~ CHa:KS
Pool"
_ Deck/Patio
. Sign
-
Porch,
Camlies Deficient
Defici
~
\.../'
-
U'
L/"'"
~
V
~
~'
~
\-/'
~/f
~
Use
Lot Width
rot Area.
Floodplain '
EZont Yard
Rear Yard
Side Yard (R)
Side Yard (L)
Parking'
Building Area
rot Area :per Family
Cor.ner rot
Other (specify)
IV. REVmv AUl'EORI'tY
The . Planni.ng Director, or appropriate designee, must approve all plans, except
the follow:i.ng: (1) Alterations or interior'l,r,Ork when the use is confonni."1q arrl
when IX) change of use is pmposed. (2) M:iintenarfce items, EJ;.g~~' ~ wi..ndcMat:'
etc., 'Nhen the use is confonning am when r.o chan<Je of\~e is. ed~...
Instances where 'WOrk ~lies with the a1xJve crita:~a.t tne" p$:mi. clm.l::e revie.-.'eC!
by the Building Inspec!:or without referral to the Planni.ng orr .~ r. '
VAPPPDVm NOr APP~
Plan COrrmission Action Required
Variance (s) Required
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IN
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~o' . o' ~f:{.; &d: .;, . . 100'
This Instrument Drafted by STEVEN T. CHRONIS
$.1."-/6',40"' 14!14.117' NII!I'
$~11i II.", CI/4 Snllu II, T:IIN.,f;
FIRST ADDITION TO FOX CHASE SUBDIVISION
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ADORESS
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NAME~.
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sueD I V. I - ~ j f:;;,x f!. 0 :(p ZONE
STREET ~O./ /~ t9 ~~
f2r~
DATE
LOT
SLOCK
SIDEWALK EXISTI NG
~ LOT DIMENSIONS
YES 0 NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
FEE: $10.00
/ I - 3.0
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tfthJ A;t
P--
I. the unders i gned, owner or agent of the above descr i bed
gradeestab I i shed before excavat i on has commenced.
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oS 8 :s) pps. If 7- '18
~
City Of Os ash 1/1/85
I -
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Address
Owner's Name
Name of Subdivision
Lot' ~;l,1'
No. of Units
Fee Required
Fee Paid
Bldg. Pennit II
Inspector's signature
Owner's signc.ture
Parks Sub. ivision
Improveme! t
Accts. Re .: 362-041