HomeMy WebLinkAbout0027799-Building
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CITY OF OSHKOSH N~
PERMIT - APPLICATION AND RECORD
27799
TYPE: BLDG % HTG D ELEC D PLBG D SIGN D ZONING /2-/ FLOOD PLAIN HEIGHT
~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ADDRESS tf90 ~~~ (!f-
aWNER !/)t!.UJA fJ..--4 ~~
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PLAN No.K; 31 0 39z~
DESIGNER
USE/NATURE OF WORK
f1~.L4~ ,d~/C ~_~/7.'
BUiLDING CONTRACTOR X~/ ~
Size ..9A-....~ Sq. Ft. # Rooms 7-3t3.d
//J
Foundation ~ Class of Const.
# Stories
~
"2..-
Height
,;2SI
~
Occupancy Permit
HEATING CONTRACTOR ~~ ";)??
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR JU~
Electric Servo New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR 1. V LJ..-?t- ~J
_BT _WH _Disp
_Lav _Sh _ow
_WC _FOr _SP
_Sink _LTub _ Eject
Other
_ WSoft
_OF
_ CBasin
_ San. Sewer
_Ur
_ Storm Sewer
_SS
_ Water
FEES: Valuation $
ISSUED BY
Permit Fee Paid $
,
cJ57.50V'
3!z.-y/Q7-
Park Dedication $ / tJtJ. dO
Final/O.P. 1- 2-'.5 .q ~
Date
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE r/ Jk!.- r k- .5 ~ d S- - 9' :)...,
AGENT/OWNER
12~ ?I;F'I~u.3
DATE
ADDRESS
/~o 17 ~" /~ / d-- '7
: ~,. r
Lf9 C--cY 7'13-
TELEPHONE #
DATE
3ft yh 2-
,
11:
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NAME .Y..~ 7 /3~
LOT I 3 V
)?~J/-tf/XrM~~L ZONE
STREET NO. S'90 ,4~ (/If.~.<) U- LOT 0 I MENS IONS
YES 0 NO 0
BUILDING GRADE ELEVATIONS STAKES seT AT SirE ~i.L.U z..S ,19 9''-'
ADDRESS
SLaCK
~';ARD
/~-
sueDIV.
SIDEWALK EXISTING
BY S ~ L.
FEE:'$'tO.OO
(/ IS: pO
A{-ZhJ~~
DEPARTMENT OF Pu8LiC WORKS
I, the undersigned, owner or agenT of the above described property agree to have the
grade estab i i shed before excavaTi on has commenced.
O^ /'!!~ t;;'O' ~
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City Of O~hkosh 1/1/85
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PARKLAND DEDICATION FEE COLLECTION RECORD
Address 9'90 ~ ~ (If-.
Owners Name l()dOYu t=~4:U~ )
Name of Subdivision ,- -. ..
Lot 1/ /3?f" Bldg. Pennit II ?-7799
No. of Units I
Fee Required
Fee Paid
lo-r ,CJ 0
lOt), "0
Date
Date 3/J-~ ~2---
Owner's sign~ture
Inspector's signature ~ ~-1~~
Parks Subdivision
Improvement
Accts. Rec.: 362-041
T N,R
LO/3 ~ Block No.
Left t /.. Right f. /
ft. 7 '/ V ft. "7 Y -z...,/ ft.
:1~;;$.$$$.Y$()U"e.$t
Nat. L.P. Oil Elec. Solid Solar
Fuel Gas *
Space Htg. RJ D D D D D
Water Htg. Ja" D D D D D
* D Dwelling unit will have 3 kilowatt or
....... . ..... more installed electric space heating equip.
}:::{::::::::::::::: Infiltration control option is: D Full sealing
of joints. D Blower door test. D Exterior
air infiltration barrier.
1< / 3f /')'?, 9?-~
State of Wisconsin SCONSI UN ORM
Department of Industry, WI N IF
Labor & Human Relations NG E M T
Division of Safety & Buildings B U IlDI P R I
Box 7969
Madison, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of Dink coovJ
PERMITFt:I!QUESTEU:;: rT7'
::,:::":::::::::::::::::::.:::.:.:.:.:....:..:::::::::::::::.::.:.... ~ CONSTRUCTION D HVAC D ELEC D PLUMBING
OW'1er's Name Il. Mailing Address
hL/hrX fA A A7n .AA~. .
Cont):.actor's Name ~ ,}7 1. u ~il!Dg Addr~s 1'7\ II / / . . ~
~ ~ - ~ A. /3,Y ~ is LV /~tJ 0 f7l/t. 1/ JI ..1) 1..... /'..J A, /1 AD /A ~ -' h
.......EZ..tra.... ..................... L t A f
:111~1~:~.llilll~il:::.. 0 rea Sq. ft. %, %, SECTION
BU~i1 Oddres~ A /~ ;/ t.i&J er SUb";~:?,.f-- ~~ A L.. ..fA /
Zoning District(s) Zoning Permit No. Front . _ R~~S
jC!. -I Setbacks;2."'$ ft. / ~
j;:eRaa.c.t::",',:...:.::....'-~:QiiUPinov::..r:$teC1:$~~:$~:QYA<<..QQ~eM.Nt: .. ..... .
Ii"INew D Repair ~Single Family Entran~e Panel !if' Forced Air Furnace
t:I Alteration D Raze tr Two family Size: i7-C ,0 amp [j Radiant Baseboard or Panel
DAddition D Move D Garage Service: D Heat Pump
D Other !2fl.Jnderground D Boiler
o Overhead l&r Central Air Conditioning
4~:~$t;~l;:FQQNIIJJQ.: ro Other
....... ..............., ..............
.................... &3-SMitaencuofancstturruecdted kTD C~ro~n~c~r~e~tyeWood l~s:Qe:'w.;M:e:~U'r::n'iPc::i"p:':"a'.1 JN$ .... .....
:~i:IR":.H.VOUY$Q:::: {j g ~
Unfinished Basement Ilf'! f Sq. ft.$:r:"$.'tO.~t;;$f .... D Other D Septic
02/ {p 1.- ~1-Story..rP$":: ;:;;:::;;;, Permit No.
~:::::rea i[,f ::::: D~;:? ~ ~~r~~~nt :~;~~~;~r~~~~~~::I::"'" .H..........H
D Other
D Plus basement
APPLICATION NO. ')779<1
PARCEL NO.
D OTHER:
Telephone
Telephone . .,/
'+4 .-0'11s
E (or\W
1;,UH.A'ftQ$$:G.~Jqm~~~aFr
Envelope 3lI:> 'S:~fLJ BTU/HR
Infiltration I Jf ~ J'I", BTU/HR
If;'~$;];:.YO;:g!NfiqQ~j;:.:?
/ /tJ I /J/J/). /) f)
$
,
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the i~suance of the
permit creates no legal liability, express or implied, on the Department or Municipality; and certifies that all the above information is accurate.
SIGNATURE OF APPLICANT DATE
CONDITIONS OF APPROVAL This permit is issued pursuant tothefoilowingconditions:Failureioc:ompl}/maYresulfiii suspension or
revocation of this permit or other penalty.
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. 188UINd)))::,:, ....
..!~11:~111"21'..':..::.'
D COUNTY Municipality Number of
Inspection Authority
.20 -.L-~k
DTOWN D VILLAGE WelTY
DSTATE....., 0 IN-DE END~T
OF: r)~~
.......PERUIiS}........ WlS"UNIFORU'PERMIT
-.-..... ........... . .
....... ... ........ ,.. . . . .
........ . ......... . ...
....... .... ........ ... ... .
j:;:JSWE)':;;):::SEAb.m;):':;:;
.. ......... . . ..... .. .. ..
!if Construction
tJ"HVAC
D Electrical
D Plumbing
D Other
.
.'
,
. .....
Municipality Number of Dwelling
Location, if different
Plan Review
Inspection
Wis. Permit Seal
Other
TOTAL
$1.(0.00
$
$30.00
$
$ /C 00
........."...,..............".............. ....,..........................................
...................,.................................... . ...............'.....'.................................'.....
'~RM~~:~19~~:~~(/';';'I;';;....,':i...,..............................
NAME ~ J,/~, - ~
DATE (j 3!i-<.f /7' L
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10 Co 31 L(
CERT. NO.
. .....^yECi::ow":'oILRR' .,>-~._., ^~'GREEN.::'fnspeCtor--'-'''>~,.'''''~.#'''wpiIllK :'''OvvnertAgent
SBD 5823 (R. 8/90) 91 K
WHITE -Issuing Jurisdiction
ADDRESS_~C:;tJ J.L~in/l y;/~
= USE J1 S rIG
.
JlO\,.JNER
. OATEl/z..,1'2.- ~ PE~IT II
~AAA/Y'
~ GENERAL CONTRACTOR
W~~k consists of_
=
-=
-=
MASON CONTRACTOR
Width of lot
-
--
ZONE
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....
o
roC
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.s:
....
0-
CD
o
DATE
----
INSPECTIONS
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.MAXLING ADD~SS
Front of lot
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if5vel.~v.T-~~ - rU d(~~6..A{-
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THIS. BUILDING SHALL NOT BE.
OCCUPIED UNTIL FINAL INSPECTIONS
HAVE BEEN MADE AND THI'S CARD
SIGNED BY THE FOllOWING IN'
DUGIf P~UMBING .....il..NS... -ECC TORe... ROUGH. ElECTRICVAlr.WO'R
~PPROVE I 5V '-' APPRO r ~ 9-
)f DATE .]11'17- !. ..' {J~' '. t. DATE~
"4.'- /i , ~ I. city 0..:1.
)SH INSP '-' ~ HKOSH 'NSP
___ .._.~. __ __RTIFICA TE OF OCCUPANCY TO os..
(A) NO BUILDING OR PART THEREOF SHALL BE OCCUPIED UNTIL SUCH
CERTIFICA TE HAS BEEN ISSUED.
IN ANY MANNER WHICH CONFLICT
IN THE CERTIFICATE OF OCCUPAI
ROUGH-IN HV AC
APPROV
INSPECTIONS MAY BE ARRANGED BY CALLING 236-5050.
. DATE",;A. 2.3-77-
DATE 7~A.3~1~
DATE. 7/'!-3/9~'
PLUMBING DATE ~472-
. (/
FIRE 236~5241 .. DATE
NOT APPLICABLE TO 1 AND 2 FAMILY DWELLINGS
SANITAR1AN 236-5030 _
_-DA TE
Only for Businesses that Require a Permit from the City Health Department.
CITY' SEALER
DATE
On'-,/ f~~.~~~~~J~~~,~~! ~~~~~ $~.~~~~._; ~M~~~ ('! -~~-~!'~~~~ q~~~~~~~,. ,~':"~ ~_'!~~:t.