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HomeMy WebLinkAbout0042479-Building/-~ CITY OF OSHKOSH - 42479 `' PERMIT -APPLICATION AND RECORD TYPE: BLDG ~ HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT -----------------------------------•~-,-1------------------------------ ADDRESS _.JL.~CJ ~0~`~~.' f `~~• PLAN NO~~ I~S 1 I y OWNER DESIGN ~~1 BUILDING CONTRACTOR /~t~3 ~Tc~C_-ZT-t-yS~ Size ~ Sq. Ft. bye # Rooms ~~ _ # Stories Height_l~ Foundation '~'~~ Class of Const. ~ Occupancy Permit ___C~ HEATING CONTRACTOR Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR \~~ ~ Nt~~ Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR ~ C"~ BT _ WH _ Disp - WSoft _ CBasin Lav _ Sh _ DW _ DF -San. Sewer - WC _ FDr -Sink _ LTub Other - SP - Ur -Eject _ SS -Storm Sewer - Water FEES: Valuation ~~ ,~,~~~~~~ Permit Fee Paid $ ~ `~1°~ Park Dedication $ ~~~•~ ISSUED BY -~ ~~ ~5~ Date (< < 4 ` Q~ Final/O.P. In the performance/6f~~s,vydrk I agr~,edto perform work pursuant to rules governing the described construction. SIGNATURE / n AG NT/OWNER p TE ADDRESS `' _ C/-~ ~~ ~ ~ ~ ,~ ~'ti~ TELEPHONE k JOB LOCATION: PROPERTY CONSTRUCTION DATA: _„~ New Construction Addition. TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) icy' , ~ ~~~ ZONING ~/~~~, COMPLIANCE CHECKLIST ~`~~ ~~~~ ~ DEFICIENT COMMENTS Use Lot Width Lot Area Lot Area Per Family Floodplain Front Yard Front Yard Side Street Rear Yarc! 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 a~;~ REVIEW AUTHORITY As per Section 30-5 Enforcement of the City Zoning Ordinance, the Director of Community Development, 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(s) DENIED or REVIEWED BY:~~"«-c-~c~ /~' `" DA ~ - ids 11~~y~ Wisconsin Departmentoflndustry, ,WISCONSIN UNIFORM BUILDING Application No. Labor and Human Relations PERMIT APPLICATION ""{ O~L"~,~~ 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 WISCOnsI Stat t 101.6 1 1.73 pro rams lPrivac Law, s. 15.04 ~) (m)J. >`>I~~.RI~~T R~'V~~T~O ;;•; nstr ^HVAC ggg ^ Elec ^ Plbg Erosion ^ Other: O~ s Name Ma~~ddress _ T le hone No. Cs~, ~ei c.lr~ f~~ !mod l~I~o ,~(/ G ~ -•.'~.-Z 9 Contractor's Name: ^ Con~ETec ^HVAC ^ Plbg i7~ iUCert A~ Mailin d re ~ Te p~p~e No. ( :p! Contractor's Name: n ^ Elec ^HVAC ^ Plbg ic/Cert # Mail g Addre Q~'C~ S~•ti~ T ' h e N~j Il) ~~v'~~~ Contractor's Name: Con ^.Elec AC ^ Plbg iUCert # M ~ ess . Telephone No. Contractor's Name: ^ Con ^ Elec HVAC Ibg iUCert # ling dress Telephone No. '.~~~ ~~'I'I~11~ L Are ~ ....... ;;, Sq. ft. 1/4, 1/4, Section , T N, R E (or) W Building Address G lD~~ S ~v n Name ~e / /j/~ Lot No ~`l Block No. Zoning i rid(s Zoning Permit No. ront Rear Le Rig t ^ Setbacks ~ ft. ~ ft. ^~'r ft. ~~ •~~ ft. vy ^ Ahe~atian ^ Repair ^ Raze g e Family Two Family Entrant el Size: ~ am rced Air Furnace ^ Radiant Basebo rd or P n l Fuel Nat L. P Oil Elec Solid Solar Add p a a e Gas ^ ition ^ Move ^ Garage Serv ^ Heat Pum P S ace Ht ^ ^ ^ Other (print): nderground ^ Boiler p g ^ ^ ^ ^ Overhead ^ Central Air Conditioning Water Htg ^ ^ ^ ^ ^ ^ Other .; ^ Other * ^ Dwelling unit will have 3 kilowatt or ;. ~:: .. more installed electric space heating equip. onstructed Crete ............. .......................... :'~:~~?~. ~.~Nll~Jl~til='>:##~:':«?'':> Infiltration control o ti n i Manufactured ^ Masonry ""~~ `~°~~ ~~~~- •°~~ ~~ ~~~~ •••~ ~ • ~~•~ ~~~~ P o s ^ Full sealing :.:: „:::.:: of " in o is Blower door t st. E ri .::>. , ..............::.:...:..:.::....:..:.:::..:. :::.:>::>:::<:>::;::;::>::>: Wood Sewer a xte or • ^ Treated 1 air infiltration rri r. ba e 1 nici al ~«~~ ~i ~~k~?#~EE?3i Other P Unfinished Basemen ~q_ ft. .. ^ z>;>;>::s :::::::::::::::::::::.:~:::::..~::: •:::: •::::::..:.~:.::::::::::..:::::::: ::<:;~ .:.:....,<::::>::;::>::»::>::»:>.::<:;: se tic ::<::?:<:~~<H' '.A't'?I~ '.:.~,::.)_::..)..:...::: >>> or Permit No. Y Envelope BTU/HR Living Area ~ Sq.ft. ^ 2-Story ^ Seasonal . '~!~*s~•J~j'># ~.~ss:;; ,. Infiltrati BTU/HR Gara e S ft. ^ Other ianent •~••~ •• P j g q ici a tilit Other Y ..........I»J~.'~.k..:,~~~..~'~.;~d..~.::::::.~ ::::::::::::::::. lus Basement ^ Priva n-Site Well The applicant agrees to comply with all appli ble s, statut nd ordinances a h the conditions of this permit, understands t t the issuance of the permit creates no legal liability, expres r ed, on th epartment or m , an rtifies that all the above informatio is curate. APPLICANT'S SIGNATURE unTE S~GNEU APPROVAL CONDITIONS This per isissued pursua to the following conditions- Failure to comply may r ult i suspension or revoc on of this permi rot er penalty- ^ Town ^ Village City ^ County ^ State of: Municipality Number of Dwelling Location: ~ ~~~ s~1 ~ ~ - a 6 6 ..... Plan Review $ ~Construdion ('`~~ep-- rt ~ Inspection $ HVAC Name ~s ~Qb•.-N(~~ Wis. Permit Seal $ ~ ^ Electrical I (~ y ~ q4 Other $ Plumbing Date Erosion ~ ~ ~ a Total $ ~_ ' S ~ S 3 Cert. No. L C/".~jp© SBD-5823 (R. 06/94) WHITE -Issuing Jurisdiction YELLOW -:DILHR GREEN -.Inspector PINK - OwneNAgent L- ~~ f~ 1~r.~ Dt >/, aad ~2 ~S -7 GATE ~~ .~_ NAME AOORESS LOT 8 LCCK -- SU801v. /~ ZCNE_ STREET N0. ,300 l~~L^-~- --- _=_,_ LOT DIMENSIGNS S I OE1rALK EX 1ST I NG YES ~ NO BUILDING GRADE ELE'/ATIONS STAKES SET AT SITE /~ 3 ,I9~gY FEE ; ~ 15.00 ~; ~UoLIC I, the undersigned, owner or agent of the aoove dascrioeC proper~~ agree ro have the grape estaaiished before excavation has commenced. 'l:•_~ ..ate. ~3 3 ,./ ' City Of Oshkosh 1/1/8j Address Owner's N Name of Subdivision C~ IZ~IQtJ~ Lot # ~J~c Bldg. Farmit # ~"1a~-~.~ No. ofi Units ' Fee Required ~- ~~ Fee Paid `~ ~~ Owner's signature Cfate Inspector's signature Oate 4 C Parks Subdivision Improvement accts . Rec.. ?,62-0=~ PARKLAND DEDICATION FEE COLLECTION RECOP,D