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HomeMy WebLinkAbout19874-Buildingi ~ CITY OF OSHKOSH N° 19874 `' PERMIT -APPLICATION AND RECORD TYPE: BLDG ~ HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING ~~I FLOOD PLAIN HEIIGHT L'Z~ ----------L,-----,(-~------------n-,-~------------------------------------ ADDRESS `~ 7 ~~ ~ 1 ~ ~-Y PLAN NO. ~ 7 ~ ~' ~ ~~0~ OWNER ,r~Gz.i~~tce~~ !/r~~,GC~.e~ l DESIGNER f~ n USE/NATURE OF WORK t'L..ll.!/~ J ~ ~ I! C~• ~iC/t-Gtg/Q~ BUILDING CONTRACTOR ~ ~J p E Size ~ Sq. Ft. 4 ~ # Rooms # Stories ~ Height Foundation ~ • Class of Const. ~ Occupancy Permit ' ~~ ~ I I HEATING CONTRACTOR L1,.wliC.t Heat ^ A/C ^ Vent ^ Fuel/System ELECTRIC CONTRACTOR / .~'~~Z Electric Serv. New ^ Change ^ Temp ^ ~ Type Fixtures Switches Receptacles . PLUMBING CONTRACTOR BT - WH Lav Sh - WC FDr -Sink _ LTub Other Disp j DW ~ i SP j Eject Heat Loss BTU'S Volts Amps Circuits WSoft CBasin DF -San. Sewer_ Ur -Storm Sewer SS Water FEES: Valuation $ ~~. ®~D~~Od Permit Fee Paid $ ~~~ "~~ Park Dedication $ ~d~ ~ ~~ ISSUED BY ~~z • ,~-~~-~~~~a:~ ' Date ~J/DI9y Final/O. P. ~~~y~l`~l In the performance of this work I agree to perform I work pursuant to rules governing the described construction. SIGNATURE ADDRESS AGENTIOWNER ~•- ~S' S ~ DATE TELEPHONE # ~~~ ~ ~~~~ ZONING/LAND'USE COMPLIANCE CHECKLIST JOB LOCATION : ~,?~/S~ PROPERTY OWNER/CONTRACTOR: CONSTRUCTION DATA: ~EW CONSTRUC'TION TYPE OF PROPOSED CONSTR~~UC~T~ION: ~(i .e. f~ ,~_~ (~, ZONING: ~~C~~ ~ Yom. ~.u~ Revised: 8/89 ADDITION ALTERATION PARKING LOT e, pool, sign, deck, etc.) COMPLIANCE CHECKLIST (Check only COMPLIES DEFICIENT applicable) Use Lot Width' Lot Area Floodplain Front Yard _ Side Street (frcrtt yard) Rear Yard!, Side Yard~(R) '~ Side Yard', (L) '~ Parking Spaces - Building. Area Lot Area Per~Famly Corner Lot Landscaping Transitional Yard Off-Street Loading ~j Vision Clearance Height C/ REVIEW AUTHORITY: - - ~~ The Director of Community Development, ;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 with the ,above criteria, the permit can be reviewed by the Building Inspector without referral to !the Director of Community Development, or designee. i l/"APPROVED I DENIED Plan Commission Action Required Variance(s) Required ~ REVIEWED BY: OATS: ~ ` / -. I i `~ V ~~~ S\ `' ti ~~ State of Wisconsin Department of industry, WISCONSIN UNIFORM Labor 8 Human Relations Division of Safety 8 Buildings BUILDING PERMIT APPLICATION NO. Mad son wl s37o7 APPLICATION Wisconsin Statutes 101.63, 101.73 See /nsbYICNOns on beck of nk PARCEL NO. ;;1=ER:~i1~T ~'Ei ~~0 ^ ^ ^ STRUCTURE HVAC ELEC PLUMBING Owner's Name Mailing Address Telephone a~ 3 f 3 h?a;~.~-U Z~3- ~~i nt tor's Name M fling Ad ass Telephone ~fl~~ ~.O~A"~ . ~. ~. ~..:....:... .:::: ~~ ` . -.:...... '~ ~:~ '/4 1/t, SECTION T N, R E or W Building Addr Subdivisi Name Lot No. ~„~ Block No. Zoning District Lot Area ~ Front Rear Left Right ~+ ~ . ft. S@tbeCkB ~ d ft. ~© ft. ~ ft. ~d ft. ~~. '~R~~''; ~: T'fE;°.;:.;::;:';;::;:; :~S:EL~~E::::;;::. ::~::::#'~ItC:~1N1~' i~.``EC~ EHQ'~~~ I#J New ^ Addition ^ Raze ^ Single Family ~ Entran P I ~~ Forced Air Furnace ~ Fuel Nat. Gas L.P. Oil Elec. ' lid Iar Alteration Repair ^ Move Two family Size: amp Radiant Baseboard or Panel ^ Other Service: ^ Heat Pump ~~ ~9• ^ ^ ^ ^ ^ ^Other Underground Boiler WaterH(g Overhead Ir on itioni Central A' C d' ' 'ng ...... Other * Dwelling unit will have 3 kilowatt or more installed electnc space heating equip. Attached ^ Detached ~ Site constructed ~ Concrete. '~~; )~;;~~i~ : .::.:::::.. . .: . . . :: Infiltration control option is: ^ Full sealing ^ M f Mason ry S oor test. ^ Exterior of 'oinffi. ^ Blower d J »'~:A':<'»><>:; ?':?<::«:<:<:<:i>:#»:z<>2>>>3> : ::.:::...::::.:::::::::::::.::.::::. anu actured ^ Treated Wood ewer Municipal . . air mfiltrat~on barner. I v ~ / 7 ~ T Basements Sq. ft. ::~F«;::'~T` `: .:;>:<: ^ Other Septic ,........ ;~~'.`:~'~::~~.. #SIC>~1 fi Livin Area ~r+ S ft ^ 1-Story - ::~$~>>>>>>>» Permit No, ; ....:..... .. ...... Envelope BTU/HR g q. . 2-Story ^ Seasonal ~'~~ :~T~`.:: >: >':: Infiltration BTU/HR ~"" Garage ~ Sq. ft. Other ~( Permanent ^ Other (~ Municipal Utility '~!~~~~;;~G~$~' ..:............................_ __ ,.:. `' ^ Pnvate on-site Well $ ~~ ~~~ Q 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, express or implied, the Department or Municipality; and certifies that all the above information is accurate. p~~j SIGNATURE OF APPLICANT ~ DATE / ' ~SII / O CONDITIONS OF APPROVAL This perm' is issued pursuant to the f lowing conditions. Failure to comply may result in suspension or revocatio of this permit or other penal ~, .ter - v o as ' .:Zf • l S ~~ L~r 0 '~~~ ^ TOWN ^ VILLAGE ~ CITY ^ COUNTY Municipality Number of Municipality Number of Dwelling .~URISD~T~DN ^ STATE ^ INDEPEND NT Ins action Authori~ P ~ Location, if different oF: - o .~- O Z ~ ... ;mil . .......:......... Plan Review $ , ~0 ~ Construction Inspection $ ^ Electrical i NAME Wis. Permit Seal(s) $ ' o ^ Plumbing DATE ~O aner .. $ 00 O ^ otner Q' ~ ~ / ~ T ~ SSV CERT NO TOTAL $ . . . isD58z3(H.¢Sq~ ~0~~ ~O WHITE-Issuing Jurisdiction i YELLOW-DILHR GREEN-Inspector PINK-Owner/Agent !"Y') DATE lS~/~flf ~ y ' , NAME~~.~JJ~ /r~~icc(,~L~E~ ADDRESS LOT o?~ BLOCK ?JAAD ~' SUED I V . ~Gt~L~~~x ZONE ~/ ,,,/ / STREET N0. °1 T ~ S /t a-/ ~" ~yni~v COT DIMENSIONS SIDEWALK EXISTING YES ~ NO BUILDING GRADE ELEVATIONS STAKES SET AT SITE ,19~BY FEE: $15'.00 PaP I l~ J DEPARTMENT OF PUBLfC WCRKS i~~~~ . I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced. 'i ~'~'~2 ~a~ City of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address o2 ~/~ ~~-~'~y~.~.L ~f- Owner's Name ~A~, Name of Subdivision Lot # ~ J~ No . o F Units I B1 dg . Permit # /9~~ Fee Required /0~ • D'-r? ': Fee Paid /~Q • D`~1 '~ ~, Owner's signature Date ~- /.S- ~4 Inspector's signature ~~ `v~~ Date ~~ Q ~'' Parks Subdivision i Improvement !, Accts. Rec.: 362-041