HomeMy WebLinkAbout0044326-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N!! 44326
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TYPE: BLDG,* HTG 0 ELEC 0 PLBG 0 SIGN 0 ZONING FLOOD PLAIN HEIGHT
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DESIGNER
USE/NfTURE OF WORK fV ~ ~\ ~G:.tk. ThI"A \ ~~ ) A~.A.\.J\~ Q, f\.}l..(,.e:
\. L~ffi L~EL "')='\~\.c:..t'\:~:J) ND "b~~ Stbu...)'\-..J
Q..) ~~ LeJ a)
Foundation
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Sq. Ft. ~ # Rooms
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q - 3~ # Stories ~.AD Height t g I
Class of Const.1 S Occupancy Permit ~--
BUILDING CONTRACTOR
Size I R-~
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
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Heat Loss.
BTU'S
ELECTRIC CONTRACTOR
CSD(V\ \~~
Electric Servo New 0 Change 0 Temp 0
Type _ Volts
Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH
~~\\
_Sink
Other
_ Eject
_SS
_ CBasin
_ San. Sewer
_ Storm Sewer
_ Water
_WC
_Sh
_FDr
_ L Tub
_Disp
_DW
_SP
_ WSoft
_DF
_Lav
_Ur
FEES: Valua.'l!l~~ Perm~ Fee Paid $
ISSUED BY _~ Date
l qSp SD
t.;\l.\\~S
4r &:>
Park Dedication $ \ DO ..
Final/O.P.
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AGENT/OWNER DA
ADDRESS
TELEPHONE 11
Wisconsin Department of Industry,
Labor and Human Relations
Safety and Buildings Division
P.O. Box 7969 ..... (See instructions on b,ack of pink copy)
Madison, WI 53707 The information you provide may be used by other government agency
WlsconsmStatutes10L63101.73 programs [Pnvacy Law,s. 15.04(1)(m)]. . /
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WISCONSIN UNIFORM BUIU)ING
PERMIT APPLICATION
Application No. .'
l\'l.\ 2~
Parcel No.
o HVAC 0 Elec .0 Plbg 'ij}6osion
II M~ny~ddrejSS ~ 7) ~
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Co..qtractor's Na~e: 0 c~n~~ q HVAC 0 Plbg Lic/Cert # Mailing Address
(~j All) ("yOrA/I'p)
C015ractor's NafJl'e:, 0 Co12, DElee ~VAC 0 Plbg Lic/Cert #
0.. II A IJ~: Id.,~". r, '" L ,
IC~tJ.i1Ctor's N~me: L.l.con NElec ~tJiJVAC/~f>lbg LidCert #
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Contractor's Name: 0 Con 0 Elec.t HVAC Q'Plbg Lic/Cert #
::~~~~II~:.!~IftI~~~i:__:~::':~~J~3 Sq. ft. 1/4,
Building Address . I L /: ,n, 5~ivision Name,
?:/:;)IO ifUPT8<:5 y/tAcE 111/,1110/1 - d -f i AIM lJ I
Zoninfl District(s) I Zoning Permit No. Frcmt I Rear Left Right
Setbacks (35" ft. I f2' ft. 2.2. t ft. ZZ- r ft
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fitfNew D Repair lM'Single Family Entrance Panel [2'forced Air Fl,lrnace Nat L. P Oil Elec Solid Solar
o Alteration 0 Rilze DTwo Family Size: IDC> amp 0 Radiant Baseboard orPanel Fuel Gas * .
o Addition 0 Move 0 Garage Service: . DHeat Pump Space Htg ........ 0 D 0 D 0
o Other (print): r!?6nderground DBoiler l!!f
o Overhead 0 Central Air conditioning Water Htg Jg 0 D D 0 0
4t:QQNSll{]YPEi .;Va~QUNQAnQNf 0 Other" * 0 Dwelling unit will have 3 kilowatt or
..'.'..'."...... ..... more installed electric space heating equip.
, ~ite Constructed u;K'"oncrete .:,q:;::::PtQMftJN&.I ':.:...:..::..::.:: Infiltration control option is: D Full sealing
J.~:AMA]IlV:Qt:VetM:~" 0 Manufactured 0 Masonry ..... ..... of joints. 0 Blower door test. 0 Exterior
..... 0 Treated Wood ~ air infiltration barrier.
Unfinished Base~~~: Sq. ft:~:;~~~~~lE$J:::::J:r::r~ ':$:;$~:Jr;:~JJJJ:r:~ 0 ~~~~~~P:~ l),f ~~~~"~~3~Q~~'~i~~~1:~~~~:~~:~:
Living Area f~ Sq ft. ~tory ~;:::~nt ~1~1:;~.4f~R:... . .:. Infiltration .~3; 33 Lf BTU/HR
Garage Sq. ft. the6:>~ DOther gMunicipal Utility j 14,.SSl\;IUltQIN.'CQST. :: .....:
[MIf>lus Basement 0 Private OncSite Well '$ 76':000
The applicant agrees to comply with all applicable codes, statutes and ordinances andwiththec6"~d1i:ionsofi:hispermii:; understands that the issuance of
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This permit is issued pursuant to the following conditions. Failure to comply may res~it~n suspension or
revocation of this permit or other penalty. .
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o Other
APPROVAL CONDITIONS
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~:ISS.UING::::.::::~~.:::::::::::::::
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DTown
Plan Review $ Llt;i
Inspection $
Wis. Permit Seal $ 30
Other $
Total $ ?D
SBD.5823 (R. 06/94}
o Other:
Telephone No.
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Telephone No.
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Telephone No.
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Telephone No.
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Telephone No.
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Mailing Address
Mailing Address
Mailing Address
1/4, Section
Lot No.
'7
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N, R E (or} W
Block No.
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o Village ~y 0 County 0 State of:
DSH-Ka..H
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~struction
o HVAC
o Electrical
g~bing
~roslon
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Municipality Number of Dwelling Location:
2::CL.;;LIL~
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Name
Date
/Sg Ito
Cert. No.
WHITE -Issuing Jurisdiction
YELLOW c DILHR I
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PINK - Owner/Agent
GREEN -Inspector
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JOB LOCATION:
ZONING/LAND USE COMPLIANCE CHECKLIST
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ZONING
tl
PROPERTY OWNER/CONTRACTOR:
S~t\
CONSTRUCTION DATA:
New Construction
Addition
Alteratio
DEFICIENT
(Le. fence, pool, parking lot, sign, etc.)
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COMMENlt"
TYPE OF CONSTRUCTION:
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COMPLIANCE CHECKLIST
Use'
Lot Width
Lot Area
Lot Area Per Family
Floodplain
Front Yard
Front Yard Side Street
Rear Yard
Side Yards
Building Area
Parking Standards .
Off-Street Loading Standards
Vision Clearance
Transitional Yard Standards
Landscape Standards
Height
Conditions of Approval
Compliance with P.C. or
BZA Conditions of Approval
Sign age Standards
Drainage Plan
-- aitdtfA) t-4r
REVIEW AUTHORITY
As per Section 30-5 Enforcemerlt oftl1eCity Zoning Ordinance, the Director of Community Development,
designee, must approval all plans, except the following: (1) Alterations or interior work when the use is
conforming and when no change in use is proposed. (2) Maintenance items, e.g. siding, windows, etc.,
when the use is conforming and when no change is proposed. -
~ APPROVED
DENIED
Plan Commission Action Required
varianc~. in d__ .....
REVIEWED BY." ~
DATE: 7'lrjs-
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1 :360
301b l-luttfc4 }/hue.
L6+ 7
I :TINcH = 30 FEEr
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21/ 3/95
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NAME~~)~Ct\
LOT. 1
S USO I v. (? \-\'Et\.SJi..~ C"QEE:T(
STREET NO. ~ \ G \-b~\€TI...c;;, '?C
~--3-
_~qb
CATE
AODRES~
SLOCK
~.; ARD
ZONE
SIDEWALK EXISTING
YES
LOT DIMENSIONS
0' NO~/
~:.l 5 , 19 95
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
8Y~-
FEE. $15.00
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,. OEPARn.~ENT OF ?UaL1C \'JC~KS
I, the undersigned, owner or agenT of the above described proper-r', agree iO have the
grade eSTaci ished before excavation has commenced.
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City Of Oshkosh 1/1/85
Name of Subdivision
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Lot #
PARKLAND DEDICATION FEE COLLECTION RECORD
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Bldg. Permit # Y'-\~
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4\lOD
Date
Address
Owners Name
No. of Units
Fee Required
Fee Paid
Owner's signature
Inspector's signature
Date
Parks Subdivision
Improvement
Accts. Rec.: 362-041