HomeMy WebLinkAbout0048143-Building
~
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
HO
N!-48143
TYPE:
BLD~ HTG D ELEC D PLBG D SIGN 0 ZONING ~ FLOOD PLAINOvt
HEIGHTM-
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - .' - . - - - - - - - - - - - - - - - - - - -
ADDRESS "6?:>S ~ \-\ c:/\ (bot ~~::J ~ ~ .
OWNER C-\c;...Si'l<. \-+("J~'j ~ Ku ~
PLAN NO.~
DESIGNER
USE/NATURE OF WORK_~ <:; F
BUILDING CONTRACTOR C~\ "-".:l~ b'-:;f ~v'bA...
Size .:b(f~ Sq. Ft.I~c/'ii'tO # Rooms 7,,3 h-ltVl1~ # Stories~ Height.J;U
Foundation ~t)J \J.L~ Class of Const. ~ Occupancy Permit r ~v: lo.!
HEATING CONTRACTOR \Sf< ~.JV
Heat 0 AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR ~,? ~ \~"""1\M-A-("'
Electric Servo New D Change D Temp D
G\~c
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
~f k:-CL...,
_BT _WH _Disp
_Lav _Sh _OW
_WC _FOr _SP
_Sink _ L Tub _ Eject
Other
_ WSoft
_OF
_ CBasin
_Ur
_ San. Sewer
_ Storm Sewer
_ Water
_SS
FEES: Valuation $ 5 a )000
ISSUED BY ~
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Permit Fee Paid $ ~:::>
Date JI-/~<"
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Park Dedication $
Final/O.P.
to pe orm all work pursuant to rules governing the described construction.
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DATE
ADDRESS
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TELEPHONE #
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NAME
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CATE
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ADDRESS
8 LOCK
LOT
SU8DIV.
STREET NO$0s{lC\f''=>.')(' P.,c.,-~ n.>.
SIDEWALK EXISTING
~.; ARD
ZONE
YES
LOT DIMENSIONS
o NO~
~A1r-<(p
8UILDING GRADE ELEVATIONS STAKES SET AT SITE
, 19
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FEE: $15. 00
I, the undersigned, owner or agenT of the above described proper~y agree iO have ~he
graae eSTaDi isned before excavation has commenced.
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1/4, 1/4, Section
Subdivision Name . / Lot No.
l\s~J~ ~IA1- ~ ~ I
Front I Rear Left Right
Setbacks ft. ft. ft. ft. I
I11iPR.QJ:E.cr::tt:???,:?:::,t:'t'?:I:m:tti?: ta~?Q(:;<;UPA8.e.'ti is.~::IC~<arm(lAtt?::: t:9~tQYA.C::e.QUIPMlNltttH:illltINlkGY:'S.fiUttClttt:fftftfttt:ttitJ
t;;;?New . 0 Repair [].81'ngle Family Entrance Panel 0 Forced Air Furnace Fuel Nat L P Oil Elec Solid Solar I
o Alteration 0 Raze 0 Two Family Size: amp 0 Radiant Baseboard or Panel Gas * .
o Addition 0 Move 0 Garage Service: 0 Heat Pump
o Other (print): 0 Underground 0 Boiler
o Overhead 0 Central Air Conditioning Water Htg 0 0 0 0 0 0
o Other i4~::CONs.T:{TYeE): 7L : ::WAlIQN::: 0 Other * 0 Dwelling unit will have 3 kilowatt or
~RU~vmim_w,:;O:~~;:~:: 8~i~tij:=d ...... ~w2~*i~~~~Tf.f!~~~:~~~~~~~
Unfinished Basement~ Sq. h. ::~::;~~~~f:nE$.:::::::::::::::::.:::: t~:~~S:t:::ttmf:?tt::?:f ~~ti~IPa m:::t:f:11:1JtQ.1rtQ$.$.t{.jijli\~f:::f:{::
Living Area ) ~OO Sq. ft. 0 2-Stor: .OS~~~~~~iHH"'HHHH' 'H"H~~~I1lI.t'~~:HHH'HU"HUUUUUH'"'' Envelope Q~~~ ~~ . ~ BTU/HR
Garage '1 L{ 0 Sq. ft. ~.~~r~v~ \ ~:;nent ~~~;:~~;;:I~;t::t:tt:::tt:II}::: mi,;:~:iit.ttnj.mINt{::tiifi:i!I:::t:::t:r:t~1:1::
o Plus Basement o Private On-Site Well $ b0, nOn
The applicant agrees to comply with all applicable codes,statutes ~ dinaflces and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, express or implied, 0 epf:lrtm~~t o~ municipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATU~ A11~ i.\ ~ DATE SIGNED
APPROVAL CON CITIONS T~\J ermit is issued pursuantto the following conditions. failure to comply may result in suspension or
..... revocation of this permit or other penalty.
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J Wisconsin Department of Industry, WISCONSIN UNIFORM BUILDING
Labor and Human Relations PER"" IT CATION
Safety and Buildings Division. IVI APPLI
P.O. Box 7969 (See instructions on back of pink copy)
Madison, WI 53707 The information you provide may be used by other government agency
Wis"consin Statutes 10163 101.73 proqrams [Privacy Law, s. 15.04 (1) (m)].
.::::.:I::.iilli.!8'!I~I~~gq.ll!::':!:ll}(constr 0 HVAC 0 EJec 0 Plbg []jrosion
Owner's Name I Mailing Address
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Contractor's Name: aCon 0 Elec 0 HVAC 0 Plbg idCert # Mailing Address
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Contractor's Name: 0 Con ~Iec 0 HVAC 0 Plbg idCert #
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COAtractor's Name: 0 Con 0 Elec []1-jVAC 0 Plbg LidCert #
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Contractor's Name: 0 Con 0 Elec 0 HVAC ~bg idCert #
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Building Address
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Z"Oning District(s) I Zoning fYermit No.
Application No.
Y8\43
Parcel No.
o Other:
Telephone No.
( )
Mailing Address
Telephone No.
( )
Telephone No.
( )
Telephone No.
( )
Telephone No.
( )
Mailing Address
Mailing Address
T
N, R E (or) W
Block No.
Space Htg
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_... o Town DVill090 )<"ity DCo,nt, DSt"o ot, M,nitiPOlity;mbO,ofDwellin9lO<ati'6
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Wis. Permit Seal $ 50 0 Electrical v V.L J
Other $ DPlumbing Date /1- 7-95
Total $ 7t) Wrosion ) (t") ~ y d fa Cert. No. ~93~
SBD-5823 (R 06/94)
WHITE -Issuing Jurisdiction
YELLOW - DILHR
GREEN -Inspector
PINK - Owner/Agent
ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCA TION:3~ss ~,,<rb,'\\ ~u..:::, ~ ~ '
PROPERTY OWNER/CONTRACTOR: ~ \.~<:,...;.~ It \1- Dvvu...~
CONSTRUCTION DATA: V New Construction
ZONING
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Addition
Alteration
TYPE OF CONSTRUCTION: (Le. fence. pool, parking lot, sign, etc.) N :; r
COMPLIANCE CHECKLIST
DEFICIENT
COMMENTS
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
Signage Standards
Drainage Plan
REVIEW AUTHORITY
As per Section 30-5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or
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.
~PPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY:
~
DATE: J J-7J1'6
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GENERAL CONTRACTOR
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MASON. CONTRACTOR
Width of lot
ADDRESS s'~.rj5 rt'-\d'Jt!1 ~"") v2-~ .
USE f\;sP
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ZONE
DATE
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INSPECTIONS
REl-1ARKS
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Front of lot
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~ MAILING ADDRESS V
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