HomeMy WebLinkAbout0036042-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
TYPE: BLDG'~ HTG 0 ELEC 0 PLBG 0 SIGN 0 ZONING FLOOD PLAIN HEIGHT
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ADDRESS '3cAS t\-o~\5<'y S '\L~ , P~N No,A.-!S;;{ 9)cr3R
OWNER S~SE Qj:;..'1D~/\ ~^f\~ I · ( NCd
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DESIGNER
USE/NATURE OF WORK
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S;i1J~LE
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BUILDING CONTRACTOR ~HO'l.A.X:1x C,.us7[;rv)
Size Sq. Ft. ~oY6 # Rooms ~ - 'sEjR.
Foundation eo~c...\<..E\E Class of, Const;
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Heighti)l} ,/
Occupancy Permit '\ cS
# Stories
'x. HEATING CONTRACTOR
blLt.:.W~
Heat 0 AlC D Vent 0 Fuel/System
Heat Loss
~TU'S
K. ELECTRIC CONTRACTOR Sc-\\(:)MI\A~
Electric Servo New 0 Change 0 Temp 0
Type _ Volts _ Amps_
,
Fixtures
Switches
Receptacles
Circuits
'iA. PLUMBING CONTRACTOR
_BT _WH
C:P~.s
_WC
_FOr
_ L Tub
_Disp
_OW
_SP
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_ WSoft
_OF
_Sink
Other
_ Eject
_Ur
_SS
_ CBasin
_ San. Sewer
_ Storm Sewer
_ Water
_Lav
_Sh
~ FEES: Valuation $ qOj C:/:X)
ISSUED BY ~j}/v\' S~
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Permit Fee Paid $ 0' '.J I> -
Date ~a'C) \ C\3
Park Dedication $ I DO '. 0..9-
Final/O.P. &./-IKlqi.f
In the performance of this work ( agree to perform all work pursuant to rules governing the described construction.
~IGNATURE~~ 4~_ ~~
AGENT/O ER
ADDRESS
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TELEPHONE #
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Wisconsin Department of Industry,
Labor and Human Relations
Safety and Buildings Division
P.O. Box 7969
Madison, WI 53707
Wisconsin Statutes 101.63, 101.73
FI - rSd.
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
(See instructions on back of pink copy)
9/93 R
Application No. ,
<3bOL/8 .
Parcel No,
:r::'pe:iUWIT:RsnUESmeQ':::tt'
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Owner's Name
-ca:..K\~ A LON
~n:ractor's Name
J~lanC.--Ase OJ;. 'TDtil\
1:"li,'II:':IIIIIIIIIII.lllli,::':11
d8l Constr 0 HVAC 0 Elec 0 Plbg
Mailing Address Ll
'Q 19 WA-S+lIlJt;;r()tJ ,rnJe,
Mailing Address A
~ES 9?S'S /1,. ~AA B.AJll
Lot Area
~ Erosion 0 Other:
1/ -Telephone No. (include ar,ea code)
Cf,H f(r:J:; If 1-1 jf-J - ~-gs:;!lS
~~I:phone No.~c1udearea code)
(kUt'c&tY fi,{J'I- 83,:;, 56/D
APPROVAL CONDITIONS
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9.) .'?i )Rmrrm!.JSs
SQ. ft. 1/4, 1/4, Section
BJ}I~~g Addr~s~, ",' <i') ~b~ivision ,Name Lot No.
':A.ftS" ~~2S. ~(,.c lY\-\cAS!\~ ~ ~PJY1. '\ \
Zoning District(s) I Zoning Permit No, Front Rea.${ Left Ri9h~.$""
Setbacks :.::?5 ft. ,0 ft. ft. ft.
fl:ilitPiQJieTm::ffmrrrr:::fttmm:::m:m:mf::mrlilifo.ttUpJJltiffmI.U:EtiGtmCAb:m::fflillrIllVA1ttElUlPMsNT::r::td:jzfmENERt'iM:sOURtEttJ:m:mmm:mm:'rrrrrr:Jf'
[S(New 0 Repair ~ingle Family Entran~nel' ~orced Air Furnace , Fuel Nat. L. P. Oil Elec. Solid Solar
l':JAlteration 0 Raze 0 Two Family Size: ~ amp 0 Radiant Baseboard or Panel Gas *
o Addition 0 Move 0 Garage , Service: 0 Heat Pump Space Htg k'1 0 0 0 0 0
o Other (print): ~Underground 0 Boiler
o Overhead gCentral Air Conditioning Water Htg I'il:1 0 0 0 0 0
::4.P'CONSlflWmtf ,11fF.QUNUA1l0N 0 Other * 0 Dwelling unit will have 3 kilowatt or
~ ~:en~~~~~~~ed ~~a:~~~ aI4::]~tU.MINm:::::::j::ii:i::i:i!:iE:::::::::j:::::I ~~r:r~~f~~1 ~~dn~:~f~~~~~~~: ~~~~~eea[,~~~.
::2FAlmAJtilVOt'VEo. '::":' .." .. 0 Treated Wood Sewer of JOlfntlts, to Blobwe: door test. 0 Exterior
Iff/"-/. :;S':':":StdRIEs..J.:;;::;'.::,;:,(: 0 Oth gMunicipal air In I ra Ion arner.
Unfinished Bg~e~ b Sq. ft. :~; _ ~t~ry " ':':....: ':,:,"':, ::::8fiUS~:(@{{{:t,::.;;,;tt'f 0 ~:~~~t No. :~:~:!!~~:;:!HI#.ln:~Q$$:lq~J,mill~~;~:~:
Living Area 6 Sq. ft. lEV-Story 0 Seasonal :::1:tMWAttER.W::mI::{I:JIrmmmmmrrm Infiltration BTU/HR
Garage oD Sq. ft. 0 Other ~~~~:;nent '~~~~i'~'i~~'I'~~i'li~~"""""'" :,..E:i$l~'i.t.j].!NG:~Qit/:::::::::::::i::::::rr:::::::::::tj::;
fil..Plus Basement 0 Private On-Site Well $ 90, ODO
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, express or imp!ied, on thJPartment or municipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE ':1 11./1 ~ l_lJt~~.J DATESIG'NED '1~ 2 Cj- 1'.3
This permit is issu~d'i)Jrsuant to the follovli'ng conditions. Failure to comply may result in suspension or
revocation of this perm it or other penalty,
CA "- ~.::';:; '"
T
N, R E (or) W
Block No.
o Other
-HjJ}jJ,
Iliiillll~'tlillliill"1111 0 Town 0 Village ~Ity 0 County 0 State of:
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Plan Review $ 'jO QQ ~Construction --:>( C:-.:... \ ~ r.. '"
Inspection $ a 'iS~VAC Name XQAJ\ ~~
~~~:rermit Seal ~ ~ ~ B ~:~~~f~~ qate 9\ SDI 0,,3 ,.
~D rosion \ 1:,\....\ 3}1'::< qLr-o
~ Cert. No, Q-...JC::,
Municipality Number of Dwelling LO,cation:
20 -06 6
Total
$ 70. CB
SBD-5823 (R. 07/92)
WHITE -Issuing Jurisdiction
YELLOW - DILHR
GREEN -Inspector
PINK - Owner/Agent
Revisa:(: 8/89 ,
ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: '2095, 't-\\.:)N~:CS' (+lM.-€ , ZQNIN~;
PROPERTY OWNER/CON~CTOR: S~~~ f'>.)S\cjfV~ ~br^\i\ES ,
CONSTRUCTION DATA: t-N&I CONSTRUCT":Ill _ADDITION ALTERATION ' -"ARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence. 001. sign. deck. etc.)
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10D.5c -::: ~ bAIJ1~ = Go L 2
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COMPL!ANCE CHECKLIST (Check only those applicable)
COMPLIES OEFICIENT
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frt:nt yard)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per Fami.ly
Corner Lot
Landscaping
Transitional Yard
.
Off-Street Loading
\ Vision Clearance ,
Height ~
RE'il&l AUTHORIT'f: ~J ~r;tD JlAf/~ · .
The Director of Community Development. or d~;~~~S~ approve all plans. except the
following: (1) Alterations or interior wor\< when the use is conforming and when no change
in use is prtlposed. (2) t~aintenance items.. e.g. si~ing. windows. etc., when the use is
conforming and when no change is proposed.
DEFICIENCY/COMMENTS
Instances where wor\< complies with the above criteria, the permit can be reviewed by the
Building Inspector without ref~rral to the Director of Community Development. or designee.
t../APl'ROVED DENIED
Plan Commission Action Required
Variance{s) Requir
REVIE'..JED BY:
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DATE: f/lf;/fl
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NAME S HOUJCASE: ~sm(f) 1100115
LOT I /
sueDI V .'PtiE-AS-fJ/OT C/cEE)2, lf7t,nJVI
STREET NO. ?:D9s flDDi6l2S H-/\!ce
CATE
ADDRESS
SLOCK
Cj) e<o/ q3
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~.l ARD
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ZONE
LOT DIMENSIONS
YES 0 , NO g
SET AT SITE ,,~,Z2,19
II '
SIDEWALK EXISTING
BUILDING GRADE ELEVATIONS STAKES
9:3
I
BY ~--
FEE ~ $15. 00
~~~
DEPART~ENT OF ?v8LIC WCKKS
,-
I, the undersigned, owner or agenT or the above described properTy agree
grade eSTabi ished before excavation has commenced.
. ~J '-11:1, -. - .,L~\"", \nO n , ·
OOfJ:838 ~ ~
iO have the
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city Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address 'jOqS r\C>N~ K1\LE
Owner's Name S~GEE ~ tbf)\€:::>
Name of Subdivision ?t\E~~~"\ C\llit~ ~
Lot if \ \ Bldg. Pennit II 3bo-tQ
Fee Required
Fee Paid
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I )(0" eQ
/
No. of Units
Inspector's signature
Date
Date gjif;Jq3
Owner's signtture
Parks Subdivision
Improvement
Accts. Rec.: 362-041