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CITY OF OSHKOSH N°- 34779
PERMIT -APPLICATION AND RECORD
TYPE: BLDG ~ HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS 7- ~ ~ ~' `~~'~~ ~ ~ PLAN NO.
OWNER ~` ~'-"~
DESIGNER
USE/NATURE OF WORK '~ - 'Z ~ L" ~ ~-: ~ ~1~~ ~7LG-
BUILDING CONTRACTOR / ,~C1
Size 7 _~ ~c L jC- Sq. Ft
Foundation
# Rooms # Stories Height
Class of Const. ~ Occupancy Permit~~'1
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles
PLUMBING CONTRACTOR
BT -- WH
Lav Sh
WC FDr
Sink LTub
Other
Disp
DW
SP
Eject
W Soft
DF
Ur
SS
CBasin
San. Sewer_
Storm Sewer
Water
FEES: Valuation $ ~ S GU • ~~ ~ Permit Fee Paid $ ~ 1~s~`~ G Park Dedication $
ISSUED BY `-~' ': /~' - -~''~ ~ Date ,`~~~7 ~ Final/O.P.
In the performance of this work I
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SIGNATURE
to perform all work pursuant to rules governing the described construction.
AGENT/OWNER
Heat Loss BTU'S
Volts Amps
Circuits
DATE
ADDRESS
TELEPHONE #
Revises: 8/L
ZONING/LANO USE COMPLIANCE C:iEC<LIST
J08 LOCATION : Z 3 / ~- ~i/~'~ ~ ~~'~'
~-z
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PROPERTY~WNER,~ONTRACTOR: ~ ~
CONSTRUCTION DATA: ~ CONSTRUCi:{N
ZONING:
AOOITION ALTERATION PARKING '_OT
TYPE OF PROPaS~ CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
/ •.
Z-~F ~7_ ~ C,1'~-~ ~~ f ~ Q~ . ~ v,r. I //A ~.~--~ L;c,t`zt.e~ 6 ~c.t rm ~i c*YI ~ ~%JZ
CDMP± IANCE Cr~EC:{LIST (Check only tfiose applicable)
CDMP!I~_ OE=ICIENT OE=ICIENCY/CDMMEyTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (fivtt yard )
Rear Yard
Side Yard (R)
Side Yard (L)
Pari~ing Spaces
Building Area
Lot Area Per Family
Corner Lot
Landscaping
Transitional Yard
Off -Street Loading
Vision Clearance
Height
RE'I IEr1 AUTHORITY
The Director of Community Oevelopmesrt, or designee, 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) Maintenance items, e.g. siding, windows, etc., when the use is
conforming and when no change is proposed.
Instances where work complies witi~ '~tte above criteria, the permit can be reviewed by tine
Building Inspector witf~out referral to tine Oirector of Community Development, or designee.
~PPROVED OFa`IIEO
Plan Commission Action Required
Variance(s) Required
RE'I I c~lEs~ 3Y : `~~ ~ ,-~--~~ OATE : ~~ ~3
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