HomeMy WebLinkAbout0038627-Building/1~
/~ CITY OF OSHKOSH N° 38627
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
-----------------------PLA----
ADDRESS _ ~~ I~ N~t~ ~~~ N NO. ~~ ~!' 7 r~
OWNER ~ ` ~ ~ ~ l~-~I~,~
USE/NATURE OF WORK
`~~~~~ ~
Si
BUILDING CONTRACTOR ^^~~ ~ + ~~.~
Size ~ • Sq. Ft. ~«~ # Rooms ~n # Stories %~~ ~~~- Height
Foundation ~l~,~esr iG Class of Const. ~_ Occupancy Permit ~_
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
ELECTRIC CONTRACTOR _ l_ ~lJN1M r~llt~S
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles .
Heat Loss BTU'S
Volts Amps
Circuits
PLUMBING CONTRACTOR
-BT -WH
- Lav ~ - Sh
- WC - FDr
- Sink - LTub
- Disp ~ WSoft
- DW - DF
- SP .~ Ur
-Eject - SS
- CBasin
-San. Sewer_
-Storm Sewer
-Water
Other
FEES: Valuation "'Y s ~ Permit Fee Paid $ ~ ~~• ~ Park Dedication $
ISSUED BY Date ~j a 5 i q ~+
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~~
AGENT/ WNER DA
ADDRESS ~ ~ O~ ~~.
TELEPHONE #
WisconsmDepartmentoflndustry WISCONSIN UNIFORM Application No. ' ,
LaborandHumanRelations BUILDING PERMIT ~j8~~
Safety and Buildings Division
P.o. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
Wisconlsi~n!S~!tatutes 101.63, tot.73 (See instructions on back of pink copy)
~j ^
>"~ • ~•~ ~ ~<~>~~»~ Constr HVAC Elec Plb Er i
^ ^ os on Other:
^ 9
`~'l
Own~'`N~ae ~ ~1'::.;»;>.:~;:~;>: Mailing Address Telephone No. (include area code)
Contractor's Name Mailing Add`eSss~, ~ ~ ~ Telephone No. (include area code)
`~[v~
...,...~.........._......,...~..w..........._.......... Lot Area
...................
...... S . ft. 1/4, 1/4, Section T N, R E (or) W
Building Address
~ .
gD JoNN~tJ ~~~ Subdivision Name ~C w - ~
~tVl Lot No. Block No.
Zoning Distri Zoning Permit No.
~ Front Rear./,ON
~ Left Right
~~
Setbacks ft. ~~ ft. ft. ~ ft.
.~EC:I' ............... .....:.:...:.~ .F .....;:.;: :.:fir.:>: >::>:::>::;: ; ;: ;;:>:.. ;: .::: <. ~::»::>:::<~;<::<:::>::>::::::>:<:»:::<:::»::>
ew ^ Repair
Alteration ^ Raze Single Family
Two Famil Entran Panel
Size:
m orced Air Furnace
R
di
B
b
d
Fuel Nat. L. P. Oil Elec. Solid Solar
Addi
i .
y p
a a
ant
ase
oar
or Panel Gas *
^
t
on ^ Move ^ Garage
^ Other (print): Service:
Under
round ^ Heat Pum
^ Boiler p
Space Htg
^
^
^
^
^
g
Overhead ^ Central Air Conditioning- Water Htg ^ ^ ^ ^ ^
^ Other
•`~~"~~~~'~`~"
~` ~~~~ ^ Other- * ^ Dwelfing unifwill have 3 kilowatt or
...
~:::::::: :::: ::..:: .:.......::::::::::::::::::
Site Constructed
Manufactured
Concrete
Masonr .:...
:: :>'»»~> .::::::>. more installed electric s a h i
p ce eat ng equip.
Itration control option is: ^ Full sealing
:... ;.
:.
• ;;:::, ' .
.:. .. .::~.~<»'<'
•• ~
... ;
: y
^ Treated Wood
ewer of joints- ^ Blower door test. ^ Exterior
.:
:.:::.::::::
~~
c~~pp :
:s>:
•
~:::-~tT
>:
::. `?»?~~>%##'<'3>~
.;;~
: •
~~
^ Other
unlcipal air in
iltration barrier.
Unfinished Basemen
t~-~O Sq. ft.
.
:
.
..
~ :::<:>:«<::....>:;.,~.,,:..~-.........,,.~......,.....,,....,;..>;::> :;:;::;:..
::<:::>::;;;
^ Y
•::
;::
~`~' `~~'"~ ""~ ` ' ~' .;>;
" eptic .
..
>::»::>:~~'.;:~I~1RT::~!~~<I:~. ~ . ~.:. . .
Living Area l ~8 Sq. ft.
2-Stor
^ y
^ Seasonal Permit No.
f
~
>
~~~ Envelope BTU/HR
f
l
~
~j/
Gara e J T'o 5
ft
9 ~(
d°-' O er
~ermanent E'
<
;
;
<t'i':E:>><~»`
........................:.:.:.:::::::.~::::::.:::::.:::::: In
i
tration
BTU/HR
.
.
q
of er
unici al Utilit
P
~M
. ~5~~.~~~~~.~~I'•~'~' .:::.:::.:......:.:...:::.;:.;
Plus Basement ^ Private On-Site Well ~ ~ C~
The applicant agrees to comply wit h all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, expresso plied, on the Depa men unicipalit ;and certifies that all the above information is accurate.
APPLICANT'S SIGNATU DATE SIGNED
APPROVAL CONDITIONS T is permit is sued pursuant to the following conditions.. Failure to comply may result in suspension or
revocation of this permit or other pe nalty.
1 ~u81rY1t-c `-[t2t~S~ Q a,~~c ~~~
"'~ ~ ~ ~<
f
^ Town ^ Village City ^ County ^ State of: Municipality Number of Dwelling Location:
OSt~ I~ost,~ zC2 _ ~ 6 6
Plan Review $ oo
Ins
ection S construction `*~' ~~
~
p
W
P
i
S
l
~-
HVAC ~
Name f-
( Q~
is.
erm
t
ea ^ Electrical
$
Other
^ Plumbing ~~ ^S ~ ~ t'
~j 'l
Date
~
Total $ ~_ erosion
^ (~ aye
~..JJ `
Cert. No.
SBD-5823 (R. 07/92) WHITE -Issuing Jurisdiction. YELLOW - DILHR GREEN -Inspector PINK -Owner/Agent
ZONING/LAND USE COMPLIANCE CHECKLIST
~~
JOB LOCATION: ~C~ ~b~~~~~ ~~ 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
~~~- ~o~' ~~~
~ ~~~ _ ~ ~~-~2
~7
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
Plan Commission Action Required
Variance
REVIEWED
DENIED
100.01 ~
_ _ _~
0
. ~ ~'
r
0
.~
O
,~
O
m
P(d~Q£R1'Y J-~NE
I
~' loA
1 ' ' '•
O
N~' 2 3~ o~~ L 54'- b" I_ 2 3 =p" N
i oa. o'
gb~oHNSON ~1VFNUE
~ORTH
LoT i .
80 JoNNSON Avg
SCALD I ~~= 30 ~-~~~
6LbcP PI.A-~ - ICo2~
City Of Oshkosh ~/~j85
PAR~KjLAND DEDICATION FEE COLLECTION RECOP.D
Address ~5 ~ ~kl. r.~~~~- \ ~ . r-
Owner's Name
Name of Subdivision
Lot # Bldg. Permit # ~~~~
No. ofi Units f
Fee Required _ ~~~, cz~
Fee Paid
Owner's signature
Inspector's signature
~/ (.ICJ 1 ~
r /d/w
ate
Date ~ a~~ Q
Parks Subdivision
Improvement
nccts. Rec.. X52-~;:;1
NAME ~ ~. ~~~~L~
LOT I
SUBOIV.
STREET N0. }~QJc,~bJ ~1v-E.
SIOEwAIK EXISTING
GarE ~ o~~ ~ ~ '
a00RES5
a I.ccK T•ra~n
ZCNE
lCT OIMENSIGNS
r t~ ~ NO
6U1l.OING GRADE ELEVATIONS STAKES SET AT
FEE;~15.00
I, the undersigned, owne
grade estab;ished before
S I TE Z-S , 199 ~ gY k',,l
OEPARTP"i=~;T OF RUES L I C 'NCr~KS
r or agent of the above dascribed property agree to have the
excavation has commenced.
I8
0
.a
w
0
y
d
m
4
01aNER ~ ~ • ~ /(
DATE ~ o2S A PERMIT #~
~~4ni ~
GENERAL CONTRACTOR
MASON .CONTRACTOR
Width of-lot
(~+ n~. i Nf~I
/~e.y ~ ~
Front of lot
___._
ZONE
Pf~
ADDRESS ~ .J~Nnl.Scr~/ ~V ~.
USE /lye ,~'-~: ~~~j ~~
WaYk consists of
-L
DATE
~~-
~U~~77
i
~~~,
~- ~~~ ~.
~~~~~
~~N/N 6 ~ DF .S1ti~t- - ~~ ~
~~ ~~)
C~ t'~ ~~ ~ , ~ ~c ~~ ~~
G`ac~ ~-
~~~rt-lo»5 ~ ~c Up- ~
___
C..t)I LL C4CL C_ C.YtI /~/6-~ ~~L~~~~,