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HomeMy WebLinkAbout1995-BuildingCITY OF OSHKOSH n PERMIT -APPLICATION AND RECORD Flo N° 45393 TYPE: BLDG~HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING ~ ~ FLOOD PLAIN HEIGHT -------------------------------------------------------------------- ADDRESS ~ 9 Z ~ ~ y S" G°-K~r`L° / e(/ ~ PLAN NO.~y ?~'~ ~~ OWNER ~ ~9 "~ C ~ ( do--sti.-~ Y" DESIGNER USE/NATURE OF WORK BUILDING CONTRACTOR_~ Si `-~"` Sq. Ft. Foundation t-- ~° Rooms # Stories l Height r Class of Const..~ Occupancy Permit ~~ HEATING CONTRACTOR ~~~-+~-{~~ Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR L--t-~ ~ Electric Serv. New ^ Change ^ Fixtures Switches ^ Type Receptacles Volts Amps Circuits PLUMBING CONTRACTOR _ BT _ WH _ Disp - WSoft _ CBasin - Lav _ Sh _ DW _ DF -San. Sewer - WC _ FDr _ SP - Ur _ Storm Sewer -Sink _ LTub _ Eject _ SS _ Water Other FEES: Valuation ~ A © Per a Paid $ Park Dedication $ ~~ ISSUED BY Date 1ST ~ FinaUO.P. In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction. ~ ~ ~~ ~~ SIGNATURE AGENT/OWNER DATE ADDRESS TELEPHONE / ZONING/LAND USE COMPLIANCE CHECKLIST JOB LOCATION: ~~7 ~ `~ ~ c~ ~ e ~'l~i~ ~~ ZONING PROPERTY OWNER/CONTRACTOR: CONSTRUCTION DATA: New Construction Addition Alteration TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) COMPLIANCE CHECKLIST DEFICIENT 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 COMMENTS 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. _~APPROVED DENIED Plan Commission Action Required Variance(s) Req REVIEWED BY: / ~~ DA 56/-b /6 ~ 09~~ l x~.pc~ xpp~ so~~C~d .os ~~ N y\ ~~ ~ N ~^"" a do ~~. ~- ;2 ~v a ~O rt ~~~~ .{- + e i ~~ ~s fk fi • '~ ~i ~ ~ t Wisconsin Department oflndustry, WISCONSIN UNIFORM BUILDING APP~icationNO. , Laborand Human Relations PERMIT APPLICATION Safety and Buildings Division P.O. Box 7969 (See instructions on back of pink copy) Parcel No. Madison, WI 53707 The information you provide ma be used by other government agency ~ Wisc nsin t s 1 1. 1 1.73 ) (m)). pro r s lPrivac Law, s. 15.04 EI Ptb osion nstr HVAC ec 9 Other: ^ Ow 's Nam Mailing Address Telephone No. ~~~ c a3/ Sza3 Con actor's Name: ^ Con lec ^HVAC ^ Plbg idCert # Mailing Address Telephone No. ( ) Cont ctor's N e: ^ Con ^ Elec VAC ^ Plbg idCert # Mailing Address Telephone No. ~ ) C tr or's N me: on ^ Elec HVAC Ibg idCert # Mailing Address Telephone No. Contractor's Name: ^ Con ^ Elec ^HVAC ^ Plbg idCert # Mailing Address Telephone No. " :> Lot Area ~~~~T ~~~i~~ .....: Sq. ft. 1 /4, 1 /4, Section , T N, R E (or) W Building Address ' ~ Subdivision Name w ~ Lot No. l S Block No. a 9a 4 ~,~ o Zoning District(s) Zoning Permit No. Fror~ntC ~ Rear SO ~ Left ~ ~~ Right Z ~ ~ Setbacks ft. O` J ft. ft. J ft. ,~ R.::...:..: ~~ ..........................:......:................................................. :....................................... . ew ^ Repair Ingle Family Entrance Panel Forced Air Furnace Fuel Nat L. P Oil Elec Solid Solar ^ Alteration ^ Raze ^ Two Family Size: _(~~ amp ^ Radiant Baseboard or Panel as ^ Addition ^ Move ^ Garage Service: d ~ ^ Heat Pump B il Space Htg ^ ^ ^ ^ ^ ^ Other (print): lndergroun er ^ o ^ Overhead ^ Central Air Conditioning Water Htg ^ ^ ^ ^ ^ Other ,,; , , ~ ~, . ~~ ~ ~~~~' ~ ^ Other ^ Dwelling unit will have 3 kilowatt or <!4<`' ~ '>~ `` ~ •' more installed electric space heating equip ite Constructed oncrete ............ <`• . Infiltration control o tion is: Full sealin Manufactured ^ Masonr ~ ~' "" "~ '" "'• ^ Y ~ of joints. ^ Blower door test. ^ Exterior ~~~#~'~~~~?>»> <« Sew ^ Treated Wood air infiltration barrier.. u n ici a I ~^^^^^^^^^~^^~^^ >:':STE~If~t~'~::::>?:<'»::?:>: Other ;>::>:<:::<,:;:::.:.:>r:.;~:::.;•::::.:;:..;.::;::.;...::>•• :~><: »::»: ~>::>:<»<::::`:<:>:: P q _ ... . ....~ .. Unfinished Basement ~ S ft. ~ ^ ,,...:;;:. .: ...:~::>::>:<:>::>::»::>:z:::<:::: ^Septic >s>>#'~#~-':~..•~...+it..~'+~.>:~~:C.:.r~~..:..:;<::<::>::> -Story ;>:~~:;'>#~::i<:::>E<><><: Permit NO. Envelope 8 ,~ BTU/HR Living Area I Sq Sq. ft. ^ 2-Story ^ Se sonal ~p ;~~~>~~~~>i>>'>>?<~;<i?> Infiltration /0 ~~ BTU/HR / ^ Other ermanent ................................................... Gara a ~~ to S ft. q 9 i I Ili ni a Ut t ^ Other u c P Y '~~~'~~.~~:~~~.~s ~.`.~. •.•l.>»><><>>< ^ Plus Basement ^ Private On-Site Well The applicant agrees to comply with all applicable codes, statut nd ordinances and with the conditions of this permit; understands that the issuance of the permit creates no legal liability, express or h ep rt nt or municipality; and certifiesthat all the above informaY n is accurate. APPLICANT'S SIGNATURE ~~ DATE SIGNED ~ J2 APPROVAL CONDITIONS This permit is issued pursuant tothe following conditions. Failure to comply may result in suspension or A /~ revocationo~thispermitorotherpenalty. ~ _ A n ~,~~~~~~ ^ Town ^ Village tty ^ County ^ State of: Municipality Number of Dwelling Location: JU~1~JL'~IC'T1±f1~[~<~ ::.:; ~ ~ d - ~ ~ >.;::»::~»:<::>::»: :<c L::::i :.. ::::.....: i:i.::.:iSIi i%:°:......... .......... ~y ...::i':F;?::•::i!•iii:isvL:Lvv';.:iL;•isi•:ii:<.iii::.i:{.i:::::<Lvi:.iiii ::> ... iii ::ass>:z>, •~ ....... TTwf{7~1~ ~.[i[:+ii: ` :. . .: ::.iiii:.:..; ~ '~`.. :'i~tl:~r.<:I~~I y I :~O>~Iit:~'E~ {~~(~~yypy.~~ ~yy .,. I M MI K ~ y ............ .. :::::C<:i::::i~Yi~ ' :~:::::::i::~??:::: ?: ~ . , . ` ::~ '~' {tt':it~W~::::;:::;:i::ii:::v::iv:i::: :?:;: ~:ii:::ii::: ............................................ ....... ................... . Y . . +:i::::: ~::::~::::ii:::ii::iii::i:iv:i:i; ::i:C:i::::::i:iii:iiiii:iiJiii~:•:::•:•:•:•:•i:•:•i:t :%:~:Lii::vi::i': vi'::: i::ii:j;:;:},v'~;:;: Plan Review $ nstruction V Inspection $ AC H Name Wis. Permit Seal $ ~ ^ Electrical ~ ~ d l Da Other $ ^ Plumbing . te Total- $ ~~ ^ Erosion ^ ~ p ~f l8 ~ Cert No ~"7" . . SBD-5823 (R. 06/94) WHITE -Issuing Jurisdiction YELLOW - DILHR GREEN -Inspector PINK -Owner/Agent GATE Q~ NAME ADDRESS LOT ~O `~ BICCK r.;,~~D SUBOIv. ZGNE STREET N0.-=q ,~~ : ,, ~~~/~ LET 0 I MENS t GNS SIDEWALK EXISTING YES ~ NO BUILDING GRADE ELE`/ATtONS STAKES SET AT SITE d f ,19~gY FEE. ~i5.U0 OE'aRT~•"•E!`:T OF ~Uo L I C '~GRK: I, the undersigned, owner or agent or the abcve dascribed property agree ro have the grade estar,iished befor? excavation has commenced. /'1 ~ ~ ~ r ~ z-~; ~-~ ~~ ~~ ...a /~47/z5 City Of Oshkosh 1 /1 /85 PARKLAND DEDICATION FEE COLLECTION RECOP.D Address ~ 1 ~~i ~ u s'c~~-`a~ ~~ Owners Name l~ w3 ~..[^ ~d Name of Subdivision Lot # f9~ Bldg.~ermit # '~~~ ~' No. of Units Fee Required ~~-~ Fee Paid Date ~~~ Owner's signature Inspector's signature ~~ Date Parks Subdivision Improvement Accts. Rec.: 36Z-041 OWI~IER ~ ADDRESS ~ZF /cu ~`'~~~~.~ DA.~E 1~ ~t.~ PERMIT #_~~ USE ~~ S"~IL- WoYk consists of /lJ~ ~i GENERAL CONTRACTOR `7/ la ~ at-- MASON.CANTRACTO' Wi~t~ of lot ZONE v 0 w O ~: d m A Front of lot DATE INSPECTIONS ~~ ~Qc ~- I7 'ma'y' T ec. Z ~.,~~ .1. .~~ ~- ~~,~.~ ~'Nt'c~~, ~ ~ ~~~~-~= MAILING ADDRESS