HomeMy WebLinkAbout0018454-Building
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CITY OF OSHKOSH N2
PERMIT - APPLICATION A~D RECORD
18454
TYPE: BLD~~TG D ELEC D PLBG D SIGN D ZONING (? ,
FLOOD PLAIN ~.HEIGHTIlj#
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -, - - - - - - - - - - - - - - - - - - - - - - - - -
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OWNER
I 7 ~ -4 /1)~ ',N..I, .J.c, '( <:;r e
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PLAN No.tJ--i"'7/- A./pok
ADDRESS
DESIGNER
USE/NATURE OF WORK
A 9~A!^-"
, -
~~~7
#~ 6-c.r-,
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Size
('f-~
# Stories
Class of Const.; (f'
'2-
Height
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~~.~
Foundation
Occupancy Permit
HEATING CONTRACTOR
/Ll~/
,
Heat D NC D Vent D Fuel/System
Heat Loss
BTU'S
Q "
ELECTRIC CONTRACTOR-V-.~
Electric Servo New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR d/l.;; ~ -
_Sink
Other
_FDr
_ L Tub
_Disp
_DW
_SP
_ WSoft
_ CBasin
_BT
_WH
_Sh
_OF
_ San. Sewer
_Lav
_WC
_Ur
_ Storm Sewer
_ Eject
_SS
_ Water
it Fee Paid $
Park Dedication $
Final/O.P.
/0(5)
,
ISSUED BY
SIGNATURE
0" pu",u.nt 10 cu'es governing Ihe desc"Oed constCU"4
h Lf~
/ ATE
ADDRESS
TELEPHONE #
Address
PARKLAND DEDICATION FEE COLLECTION RECORD
w&tk
Owner's Name
City of Oshkosh 1/1/85
Fco,c f~--e -- 1-'
Bldg. Permit # I fl-lf~-r
Name of Subdivision
Lot # -<17
No. of Units ;I
Fee Required
Fee Paid
Owner's signature
Inspector's signature
Parks Subdivision
Improvement
Accts. Rec.: 362-041
6.y -? -A(9ol?-
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WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
See Instructions on back of
~TRUCTURE 0 HVAC
Mailing Address
APPLICATION NO.
State of Wisconsin
Department of Industry,
Labor & Human Relations
Division of Safety & Buildings
Box 7969
Madison, WI 53707
Wisconsin Statutes 101. 63,101.73
PARCEL NO.
o ELEC 0 PLUMBING
Telephone
{ ~se
Contractor's Name
Mailing Address
Telephone
...........................................................-....... ...................
..................................................................................................................-................... ..................
...................................................................
.111~.I~lllllrn'IN,;"",.:.:.{
%, SECTION
I
,T
Lot No.
N, R E or W
Block No.
Rear
Left
ft.
Oil Elec. Solid olar
*
D D D D D
D D D D D
Basements
..............,.,...............,.,.
...:cl!iI#ijl~~~l:'lS.).
00 BTU/HR
BTU/HR
Living Area
Garage
SIGNATURE OF APPLICANT
CONDITIONS OF APPRQVAL
DATE
Failure to comply may result in suspension or
'~4
..,.............................
................................
.. .............................
~!lrill~iBi:
o COUNTY Municipality Number of
I nspection Authority
Municipality Number of Dwelling
Location, if different
..,......,.,....,..,...........,................,.........,....,.,..,.,..,.,."......,.,.......d.............,.".,.,..,.,..
.d.............,................................................................,...'.........'.,..,.,..,...........................
~E~Mj.SSUtiOBYf}r})...:..,:.........,. .......,...... .
.'.............'..........,.,....'..".......,...............,........-..........,..................................,...
......d....._....
Plan Review . . . $
Inspection . . . . $
Wis. Permit Seal(s) $ ~
Other . . . . . . $
TOT AL . . . $ 7'0
SBD 5823 (R. 04/87)
/Df).
Construction
HVAC
o Electrical
D Plumbing
D Other
NAME
/!-I!r,.. bo<"l {'(:
rJ../ -~~- ?,O
~~,y'O
DATE
CERT. NO.
WH.ITE ':".Issuing Jurisdiction
YELLOW - DILHR
GREEN - fnspector
PINK - Owner/Agent
". 4h-<lff)
~
DATE
~. f2 voSe' {
NAME 7 <P~ ADDRESS
LOT 47 BLOCK HARD
SUBDIV. ~.,:~ ZONE
"-
STREET NO. /7(.,1 tJ~lJc.15{:'(..rf!'P tUvL-OT DIMENS !Ot:JS
SIDEWALK EXISTING yfs 0 NoB
BUILDING GRADE ELEVATIONS STAKES SET AT SITE ~!~S, 19qO
. l
BY 'y<'t,J
FEE:
$I~
G~
~~.v
DEPARTMENT OF PUBLl C WORK~. &..
04\143
p.rope.r~. e to have .,he
r;'~
, .
t/~ --1
t
I, the undersigned, owner or agent of the above ~escrib
grade establ lshed before excavation has comme ced.
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~. ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: (7(..,"; ?Val. ~".t~r<:rf" r-t;b/
PROPERTY OWNER/CONTRACTOR: ~~
CONSTRUCTI ON DATA: ~EW CONSTRUCTI~
Revised: 8/00
ZONING:
ADDITION
AL TERA TI ON
PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence. pool~~n. deck. etc.)
. AJ~. ~~. ~ .;#/-~_
. COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT
Use
Lot Width
Lot Area
FloOdplain
Front Yard
Side Street (f~yard)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per Family
Corner Lot
Landscaping
Transitional Yard
Off-Street Loading
Vision Clearance
V-' Height ~
REVIEW AUTHORITY: ~ . ~hflC) ~1e
The Director of Community 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 Required
Variance(s) Required
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REVIEWED BY:
DEFICIENCY/COMMENTS
DATE:
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