HomeMy WebLinkAbout0020221-Building
\-'f
~-
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
20221
TYPE: BLDG [)I HTG 0 ELEC 0 PLBG 0 SIGN 0 ZONING )'2;1 FLOOD PLAIN
HEIGHT 2-'f I'
ADDRESS /79f:~...h #t/~ ..f~'r'U/->>~~.I.J ..!:iLPLAN NO. P7/37R9tJ/Z-
OWNER .~ f ;eV~~
DESIGNER
USE/NATURE OF WORK
YleMJ 1.? ~
*' -
tZd:~
BUILDING CONTRACTOR ~~ 1- ~
- Cf Be./)
Size lite" Sq. Ft. ;lIP 13 # Rooms
Foundation ~
R
# Stories
R
~ Height ~c{' r
Occupancy Permit /L.E 4.
Class of Const.
HEATING CONTRACTOR ~~ ~r
_ Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR (J,~~
Electric Servo New 0 Change 0 Temp 0
Type_ Volts_ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR ~~
_BT _WH _Disp
_Sink
Other
_FDr
_ L Tub
_DW
_SP
_ WSoft
_DF
_ CBasin
_Lav
_Sh
_ San. Sewer
_WC
_Ur
_ Storm Sewer
_ Eject
_SS
_ Water
FEES: Valua"JkiAl ;o:;:;;~permlt Fee Pa;d $ ~S'1.:4? · . Park Oed;c.';on $ /OOdX)
ISSUED BY _ '/ -' Date'f!~11 '(f.e , /1I)/9a Final/O.P.
SIGNATURE
agree to perform all work pursuant to rules governing the described construction.
9/10/90
DATE
ADDRESS
TELEPHONE #
Revised: 8/fB
ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: ~ ''It "'.M1~ ZONING: ;Lr
PROPERTY OWNER/CONTRACTOR: ~- E( ;t~ ~
CONSTRUCTION DATA: ~EW CONSTRUcnON ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
'Yl~ 1.~ /C I2d ~ .
. -
-
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frmt 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
REV'EW AUTHORITY: _:;!~r7rJ V~tf--/!- .
The Director of Community Development, or d~~ne;, 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.
L----Al'PROVED
Plan Commission Action Required
Variance(s) .R~
REVIEWED BY/\/~/~ '-
DEFICIENCY/COMMENTS
DENIED
i~d/20
.,/ ..
DATE:
State of Wisconsin
Department oflndustry,
Labor & Human Relations
Division of Safety & Buildings
Box 7969
Madison, WI 53707
Wisconsin Statutes 101. 63,101.73
f11/37fr;OJe-
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
See Instructions on back of ink co
APPLICATION NO. ;J..ti2- 2-l
PARCEL NO.
....... . .....
....... .. ....
..... ..... .... .......
.... ,_... ..... .........
. ... .. ... ...... . ....
:pII"UI:R,loUlsg.::
D HVAC
D ELEC D PLUMBING
Telephone
3t- 4, 32..-"3
Telephone
STRUCTURE
Mailing Address
2Z(,0 ~
Mailing Address
............. ...... ',-,' ...... ......... ...............
111~1~lillll~lj~~:-::-::-'-,':::,":::--::,'::::i!i,-'::--:'::-,
%, %, SECTION ,T N,R E orW
Name Lot No. Block No.
~ L/-~
Front Rear Left Right
Zoning District
<..- - I
ji(:PAOJ.~C;l?}::f:{ .-...
o Detached
~ Site constructed
Ll Manufactured
Concrete
Masonry
o Treated Wood
o Other
:1Q~::P(iuMI..HI,::r:'
~wer
Municipal
Septic
Permit No.
~ ~ ~
f: :lIF~N~A$Y$Ou..m;:::{i{
Fuel Nat. L.P. Oil Elec. Solid lar
Gas *
Space Htg. 0 0 0 0 0
WaterHtg. 0 0 0 0 0
* 0 Dwelling unit will have 3 kilowatt or
___ more installed electric space heating equip_
--- --:r: Infiltration control option is: 0 Full sealing
of joints. 0 Blower door test. 0 Exterior
air infiltration barrier.
o Other
S . ft. Setbacks ft.
a.- -1YPE::__ :f.W~t.~.~::~Ul.Ac:$;Wn,'MU;Nt: ..--
!XI Single Family Entrance Panel ill' Forced Air Furnace
o Two family Size: ..!J#f) amp tJ Radiant Baseboard or Panel
o Other Service: 0 Heat Pump
1;81 Underground 0 Boiler
o Overhead 0 Central Air Conditioning
______ _____ :4i.:IQ.&~1MEQP.:"OI1JQ":: 0 Other
'!KNew 0 Addition 0 Raze
tiAlteration 0 Repair 0 Move
JfIAg::f,_--- ---
Basements 13 ~ 0
Living Area ;2b 73
(psI
Garage
Sq. ft.
Sq. ft.
Sq. ft.
o 1-Story
I1f 2-Story
tJ Other
'#U$.~::::::: _...
o Seasonal
(]\permanent
o Other
:11;:114....1::: .-
I)a Municipal Utility
o Private on-s.ite Well
$
$.!~,:..1tQ.'~ __ --.
SIGNATURE OF APPLICANT
CONDITIONS OF APPROVAL
DATE
The applicant agrees to comply with the Wisconsin Uniform elling ode and other nicipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legalliab', . press epartment or Municipality; and certifies that all e above information is
accurate.
This permit is issu pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this p rmit or other penalty.
Plan Review . . . $ '10
Inspection . . . . $
Wis. Permit Seal(s) $ 3&
Other . . . . . . $
-Zo
TOTAL . . . $ _
SBD 5823 'IJ!!t) r!J-tY'1) . ,'r-f)
o TOWN 0 VILLAGE Iir CITY 0 COUNTY Municipality Number of
o STATE DINpEPEN9ENT Inspection Authority
OF: t1~~ LfL-;2.~~
':"':""""'PERMtrfSY"""""" WIS/UNIFORM"PERMIT.
:I::/.:$SUEIJ,:::f:t:::t:}::SE!AL'N()1tJtt{I,
I1f Construction
o HVAC
D Electrical
D Plumbing
D Other
Municipality Number of Dwelling
Location, if different
.................... ......... ..................
.............................
.............................
.............................
I$SIIN.
i:a~..:~~I!~.NI:
NAME ~ k/A~
DATE (I i/31/9p
CERT. NO. :255'0
,
r'
?(P9foo
WHITE -Issuing Jurisdiction
YELLOW - DILHR
GREEN -Inspector
PINK":Owner/\
-""
DATE
sf~a/~
#'-
NAME ~~. !6{vA/ ~
LOT . Ill, -
SUBDIV. ::Irk ~ ZONE
STREET NO. 17 98 yJ ~ I.. W ~~ ~~ 1~~S"ioNS IV ~ :::t
SIDEWALK EXISTING YES 0 ~O III
BUILDING GRADE ELEVATIONS STAKES SET AT SITE ~~ ~J
FEE: $15.00 fD
ADDRESS
BLOCK
HARD
,19 ~.
BY p1YC/
. DEPARTMtNT OF PUBLl C WORKS ::c
. . ,k':. c:> ,
I, the undersigned, owner or agent of the above descri d property agree to have the
grade establ ished before excavation has commenced.
G~
y~
O~Z?~
1~CY;3
/
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /79/1Jd <<J~ ~~-L/
Owner's Name ~ f I&.~ . .
Name of Subdi vi si on ",./if- (1-ALI'~
City of Oshkosh 1/1/85
""-'
. ", ...,
Lot #
~"
Bldg. Permit # ,;202-2-1
No. of Units /
Fee Required ItJo, 0 {)
Fee Paid-
Owner's signature
Inspector1s signature
Date
Date
Parks Subdivision
Improvement
Accts. Rec.: 362-041