HomeMy WebLinkAbout0019122-Building
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
19122
fYPE: BLDG :ra(HTG 0 ELEC 0 PLBG 0 SIGN 0 ZONING 7G (
FLOOD PLAIN
HEIGHT
~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ADDRESS ~ ? / 'Z--..':3 ~.r-,/.::s()'1
OWNER t..J I """'- e {,.CL-~ 0 ~7
DESIGNER
USE/NATURE OF WORK .PVeeAJ ..s:(e:: ('c.
PLAN NO. i-::>.tf~?.y"'h2&k-
It>Jr'~ IL'f/O~7
et/
# Rooms l?+ "2-PfL # Stories <<Q{ I c:.......J Height~
Class of Const. ~ Occupancy Permit ~
HEATING CONTRACTOR
Heat 0 AlC 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
t Fee Paid $
Dat
I
t/'
ISSUED BY
Park Dedication $ ~
Final/O.P. t - ?; ef/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE'~ ~~
AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
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State of Wisconsin
Department of Industry,
Labo.r & Human Relations
Division of Safety & Buildings
Box 7969
Madison, WI 53707
WiGconsin Statutes 101. 63,101.73
APPLICATION NO.
PARCEL NO.
.........................
..........................
........................ .
......... ........................
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D ELEC D PLUMBING
Telephone
Telephone
iRBIJ~~IL<tlllg.:}::
......
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Subdivision Name
<....
%, SECTION
,T
Lot No.
zD
N,R
Block No.
E orW
o '"'-
Setbacks
:'ii!i':':':':"E"'ILE"':~,Hoii:liti'i::::
:~ub:~ :~ ~::I:~
........................................ .
Left. _ Right Co-
ft. /~ ft. 7 .
::ff1:~~:i$..$.I~;V$QU.c$.m::
Fuel N. L.P. Oil Elec.
G s *
Space Htg. D D 0 D D
WaterHtg. D D D D D
* D Owellin unit will have 3 kilowatt or
more installed lectric space heating equip.
. .... ::.:...........................::. Infiltration control option is: DFul1 sealing
.... of joints. 0 Blower door test. 0 Exterior
air infiltration barrier.
ft.
Living Area
................... ........
...........................
................... ........
..........................
al~:tmI1tI.O'$$?Qiil:'~ijiMijijFr
Envelope "3 (p frO BTU/HR
... It Infiltration V BTU/HR
~'j;j:tES*:e:liil..)~I.i.~~s.......*.
=:~:~~~::=:::............::~~~:~::~...~M:..~JM::M~....)~~:: ....
s:- 700
$
Garage --
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Municipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legal liability, ex ress or i. Ii Department or Municipality; and certifies that all the above information is
accurate.
SIGNATURE OF APPLICANT
CONDITIONS OF APPROVAL
DATE
This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penally.
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Municipality Number of Dwelling
Location, if different
......................... .
.... .....
... ....
~r!~"lj1N:::f
ITY 0 COUNTY Municipality Number of
Ins.p.;Ption Authority
LO-~t:
=:=:::=:=:= WISlUNlFORM:='ERMIT:
I:::tttttSEAtltO>itt{{
Plan Review . . . $
Inspection , . . . $
Wis. Permit Seal(s) $
Other . . . . . . $
TOTAL . . . $
------~_. SBO 5823 (R. 4/89)
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'onstruction
VAC
o Electrical
o Plumbing
o Other
NAME
DATE
CERT. NO.
WHITE -Issuing Jurisdiction
YELLOW - OILHR
GREEN - Inspector PINK - Ownerl Agent
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1513/- 3'/ (155,' 2.3T~
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NOTICE
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~C'" SECTION 7-32 CERTIFICATE OF OCCUPANc:Y .TO.BE; ISSl,JE;P
(A)
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The Building Inspector, Heating Inspector, Plumbing Inspector,
and Electrical Inspector shall make a final inspection of all
new buildings, additions, and alterations. If no violation of
this Chapter or other laws or lawful orders be found, the Chief
Building Inspector shall issue a Certificate of Occupapcy, .
stating the purpose for which the building is to be used, also
the maximum load and ma:l';imum number of persons that may acc-
omodate on each floor thereof and also t:hat the building or
premise or part thereof and the purposed use ther.eof are in
conformity with the provision of Chapter 30 on Zoning and
City Planning, as required by Section 30-27 (C) of said Chapter.
NO BUILDING OR PART THEREOF SHALL BE OCCUP.IED UNTIL SUCH
CERTIFICATE HAS BEEN ISSUED. NOR SHALL ANY BUILDING BE OCCUPIED
IN ANY MANNER WHICH CONFLICTS WITH THE CONDITIONS PUT FORTH
IN THE CERTIFICATE OF OCCUPANCY.
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PRe s e'N T T HIS CAR 0 "; ~ode ~; '" RqUGH ELECTRICAL WIRIN~
FOR OCC~P'ANCY r,ERtT. T:.,. o~~~~.'JlePRQVED
T HIS B.UJ L 01 N G S r" 9itr9f i- DATE /-~7- 9/
A'< .. ,.' ,.i:, ...., '.-,.,.. ' 3" ()SHl<q~H. INSP /)hJU1.-u.C,i~l
NOT' BE 'O'C COP I E'D U N Tr[-~-~--~'~"~"~"'-~ '
.~.~~~~~:~,~~ r~O~~I~PRovEB' .-,= ",
aSH . DA TE . . ?'::?{ r?/
THIS' CAR'D,'SIGN E~-=-:}"~,,~N~.,.~k""""
THE. "'FGCLOWI'N G I N',,' N sp EC T-I~~~":-M~:;:
SPE CTdR S 'c"': "A~R~NGE~:8Y pt:E...~~G
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PL U MJ3 IN G,.. "kJj2"'?'1 0 ATE 1;'64_, Y.:....7/
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