HomeMy WebLinkAbout0025934-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N~
25934
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ADDRESS ;;lO("~:::'~ PLAN No.r'l1l9 I09/1'L.
OWNER ~.- fJ:m----.------
DESIGNER
USE/NATURE OF WORK 0J.../~
d'~~ cu;r ~,
~ ,
Pr ~ ,oJ.~~A< I"~ ~ 7ft.:
BUILDING CONTRACTOR V~ A!I~ . 'If) ! <.:
. ~ .,3-/3d ~ W, E:C--I. . . I
Size- Sq. Ft. # Rooms. {) # Stones "'2.- Height 2- C;
Foundation ~ Class of Const. .s:: Occupancy Permit ~
HEATING CONTRACTOR~
Heat 0 NC 0 Vent 0 Fuel/System
'\
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo New 0 Change 0 Temp 0
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
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FEES: Valuation $ Ilo,()OO.DO Permit Fee Paid $ .3oS",()O
ISSUED BY ?4<- :d'..Jk~ Date /O/Z2--)7/
Park Dedication $ 100.0 ()
Final/O.P. S- - d D - y ';;?
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~~ - /i",,,"ry .~
CJd .2", 9 /
DATE
ADDRESS
TELEPHONE #
ZONING/LAND USE COMPLIANCE CHECK~IST
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JOB LOCA T1 ON: 20 ~ <("" I-!. c.L~ t ~ ~
PROP~RTY OWNER/CONTRACTOR: . .q)',t, r' e c
CONSTRUCTION DATA: ~ CONSTRUcnKN ADDITION
f-'
~
Revised: 8/89
ZONING:
~~I
~
ALTERATION
PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
t:Veu.5 /kx.9~e_ a~ /tit (~q
. COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frantyard)
Rear Yard
Side Yard (R) J1J1AL -IJ~ c~~JL/L~ }yJ
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per F amUy
Corner Lot
Landscaping
Transitional Yard
Off-Street Loading
Vision Clearance
. Height . .
REVtEw AUTHORITY: ~ ~I/U) ~
The Director of Community Development, or de~;ne;,Jmust 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) t~aintenance items,. e.g. sid.ing, 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
Bvilding Inspector ~ut ref~rral to the Director of Comm4nity Development, or designee.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Required ~ .
REVlE'.ED BY: ~ -~
/ .
DEFICIENCY/COMMENTS
DATE:
/cJ/g~/f'!
/
State of Wisconsin
Department of Industry,
Labor & Human Relations
Division of Safety & Buildings
Box 7969
Madison, WI 53707
Wisconsin Statutes 101. 63,101.73
.:x: tf //1 109/ It"
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
(See Instructions on back of Dink coovJ
APPLICATION N\). ~ -Sq.3 tf
PARCEL NO.
. . . . . . . . . . . . . ..: .. . . . . . . . - . .. . . . . .. . . . . . . . .
:1111~11.llllllllliiilllll.gcoNSTRUCTION D HVAC
Owner's Nrme I Mailing Address
s.1j--t(_~ 2..1<'; e tV ; C- Z.
Contractor's Name f J
tA.YCUJIl. fI ~v I'\..ca-'I"
:lllllllilllli~lll:iiill Lot Area
BUildin~ A~~T' \ I
ZO~s:- H- i'c.J,t:_D~Y A&l. (/( €-
Zoning District(s) oning Permit No.
~\
j.;:PAOJ!01tt ....
~~:ration
DAddition
D ELEC
D PLUMBING DOTHEH:
Telephone
Mailing Add;:;~ /V">, /'t r
/92-0 lZr ~'tJJ~ l y-
Telephone
Z_3"=?..... 01 ~f
~,
Subdivi~n Name
_ !)IP~ Pf/lE (
Front I Rear _ i-'
Setbacks ~-ft. 7 j.
IWEtactRlCAU...~avAC~QQ'eM:EN1F
Entrance Pa~1 ~orced Air Furnace
Size: 70 amp 0 Radiant Baseboard or Panel
~vice: 0 Heat Pump
~ Underground lD 6eiler
o Overhead ~ntral Air Conditioning
o Other ~~:~=~~~!I1Jg" HI~Qt~~~UNJ;nNG:':':..tt
z::..n.VQ4.:yeo:tt 0 Manufactured 0 Masonry Sewer . .HHHH
HHHH..H 0 Treated Wood ~unicipal
!3:l!'$:$TOIIES' .H 0 Other 0 Septic
~;:;:~':~::~;;fo : : ~~m~' ~:,"" ;te,;;aW! m m ......m...
Garage JLJo Sq. ft. 0 Other "roo~rmanent .lE::"Municipal Utility
Other !IT Private on-site Well
o Plus basement
Sq. ft.
~, SECTION
T
Lot No.
2~~
N,R
Block No.
ElorlW
o Repai r
o Raze
o Move
... ..~~:.pj~"Mf.
.3Single Family
o Two family
o Garage
o Other
Left Right
ft. 'C-O ft. cO ft.
........11;ENEa~MJ~bQ$eE::
Fuel N t. L.P. Oil Elec. Solidlsolar
s *
SpaceHtg. 0 D ODD
Water Htg. D D D D 0
* D Dwelling unit will have 3 kilowatt or
more installed electric space heating equip.
HH. Infiltration control option is: DFull sealing
of joints. 0 Blower door test D Exterior
air infiltration barrier.
1IiJlU$..'tt.O$$ie;'\)9~I~W~i:hI
Envelope .39/)90 BTU/HR
.. Infiltration .303/ 'Z..- BTU/HR
jl~::~$;T;IQ'WglJ~:gl~mf.
$ /"'10000-
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the cqnditions of this permit; understands that the issuance of the
permit creates no legal liability, express or implied, on the Department or Municipality; and certifies that all the above inforl11ation is accurate.
~ a. n'~ DAT~. eq:rey ?!'
SIGNATURE OF APPLlCAN~ -
CONDITIONS OF APPROVAL This pe~mit is i,ssued ~uJD?r;t to-?t;e following conditions.
revocation of this permit or other penalty.
Failure to comply may result in suspension or
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$30.0 0
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J WHITE -ISSu!njl Jurisd1cjion r
10 000 ~/o /l/l €c",,- ,
o VILLAGE JJf CITY D COUNTY Municipality Number of
o INDEPENDENT Inspection Authority I
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1;1 ftW!i;m,]~~~;;;:irF{.::: ..... .
lorconstruction
[J'HVAC
D Electrical
D Plumbing
D Other
Municipality Number of Dwelling
Location, if different
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'J:~t::):{),',:,:,',:,:,',.".:,.,.::,:")t,",:,,.,"""".",,:))) OF:
97 ~2s
NAME~ lu~
DATE /()/z.'-z./~/
~ S"~O
CERT. NO.
YELLOW - DILHR
GREEN -Inspector
PINK - Owner/Agent
....
DATE
/€:> - Z-I - ? (
..
NAME tJe_ '!~€- Get! Jlt;,J-
LOT 'd: 8-3
SUSOIV. JJ1ge~ I
STREET NO. c2ot.,5 1Ir'c- k.:~v
f
ADDRESS
BLOC K
~.I~B.D
ZONE
J...CUI\_ e
SIDEWALK EXISTING
YES
LOT DIMENSIONS
o Nota
10 Il.l
SUILDING GRADE ELEVATIONS STAKES SET AT SITE
,19 q I
BY K,J
FEE:~
rj" r:;; c,o
c?'~
!DEPARTMENT OF PliaLiCWORKS ~L?
I
1, the undersigned, owner or agenT of the above described properTY agree TO have the
grade estabiished before excavation has commenced.
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City Of Oshkosh 1/1/85
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PARKLAND DEDICATION FEE COLLECTION RECORD
Address ;}.o(P5"';(!~ /dY .. ,
Owners Name ~A'T~'/~,
Name of Subdivision /J~ ,~
Lot # dl...3 Bldg. Pennit # ;lS 9 3 i
I
Fee Required
Fee Paid
I
I t9t!J ~ 0 ()
IOa.do
No. of Units
;::::::o:~:n:::::tu~~~
Date ({)c-f ~VI 7/
Date /1J!z.-z-/qJ
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Parks Subdivision
Improvement
Accts. Rec.: 362-041
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DATE PERMIT #
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S- 1''::) ... ~I ?f--
MASON. CONTRACTOR
Width of lot
ADDRESS 2,01,>: ~~ M--
USE h J'r/L
Wo~k consists of
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Front of lot
ZONE
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INSPECTIONS
REl-1ARKS
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$L ~~~
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MAtLING ADDRESS
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OCCUPIED UNTIL
. .
HAVE BEEN MA
.DBY
INS.PE
..INSPECTIONS MAY BE ARRANGED BYCALLlN.(3.........236-5050..
.. , ". .. ','-,' I ' "
BUILDING
ELECTRICAL
REA TING
.PLUM81NG
DA.T
.DAT
DATE.
DATE
FIRE 23$-5242
N(lT APPl..ICABLETOtANO. 2
.. SANITARIAN23~-5b3o.
Only for Buainf;llues that
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