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HomeMy WebLinkAbout0019437-Building~ CITY OF OSHKOSH N° 19437 ~' PERMIT -APPLICATION AND RECORD TYPE: BLDG~(~ HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING ~ ~ FLOOD PLAIN HEIGHT Z-~~ ADDRESS PLAN NO.~-~ ~~~ ~~ ~ OWNER DESIGNER ~~ . USE/NATURE OF WORK BUILDING CONTRACTOR Size n Sq. Ft. # Rooms # StoriesQ Height ~/ Fni~nrhfinn l"~yr !`hcc of f`nnc+ /J (lnn~inonnv Pnrmif /L~ HEATING CONTRACTOR Heat ^ A/C ^ Vent ^ Fuel/System ! Heat Loss BTU'S ELECTRIC CONTRACTOR _- ~ ~ Electric Serv. New ^ Change ^ Fixtures Switches I Temp ^ Rece Type ptacles Volts Circuits Amps PLUMBING CONTRACTOR ~ BT WH Lav Sh WC FDr -Sink LTub Other Disp DW ; SP ; I -Eject I WSoft DF _ Ur SS CBasin _ San. Sewer -Storm Sewer -Water 1'CCA: VdIU3ilOn ~ y ~+ ~ Vv V ~ yV rermit ree raio ~ ~ ~ ~' ~ ~ Park Dedication $- /yo ~ ~" ISSUED BY ~~~ ~, ~ ~ Date '~~/7/~a Final/O.P. In the performance of this work I agree to perform all SIGNATURE ADDRESS ~~ pursuant to rules governing the described construction. DATE TELEPHONE # JOB LOCATION: ~.~~(~ i ZONING/LANG USE COMPLIANCE CHECKLIST PROPERTY OWNER/CONTRACTOR: ~ CONSTRUCTION DATA: /NEW CONSTRUCTION TYPE OF PROPOSED CONSTRUCTION: (i.e. fey t ~ oar ®, i Revised: 8/Q7 NING: ~ / ADDITION ALTERATION ce, pool, sign, deck, etc.) PARKING LOT COMPLIANCE CHECKLIST (Check only those DEFICIENT Use Lot Width Lot Area Floodplain. Front Yard'. Side Street (frarrt Rear Yard Side Yard (R) Side Yard (L) Parking Spaces Building Area Lot Area Per Fami Corner Lot Landscaping Transitional Yard Off-Street Loadin Vision Clearance Height applicable) DEFICIENCY/COMMENTS yam) ly 9 REVIEW AUTHORITY: /0`0, ~o The Director of Community Development, or designee, must approve all plans, except the following: (1) Alterations or interiorjwork when the use is conforming and when no change in use is proposed. (2) Maintenance items; e.g. siding, ,windows, etc., when the use is conforming and when no change is proposed. Instances where work complies with the Building Inspector without referral to APPROVED Plan Commission Action Required Variance(s) Requited ~, REVIEWED BY: e criteria, the permit can be reviewed by the Director of Community Development, or designee. DENIED ~- DATE COMPLIES `~1 ~~ 0 n a a i ~ ~" // S'- 7 j D /~ Building Address ~ a ~ ,,.~ Su n a e Lot No. Block No. Zonin istr t ~- ~ Lot Ar a . ft. ~ S@tbedc8 ~ Front ~ ~ ft. Rea/r `E' I ft. Left ~( V ft. Right ~~ ft. ~€a.;..l~l#~T ' < '' ~ .. ~ .............. .~... ~.~~`A~.....; . ~... ~~.I~IP~. ;. '',' `;. .~.~....>~I ERQ~'.:$O ~I~ £E ~ew ^ Addition ^ Raze Alteration ^ Repair ^ Move ~ Single Family Two family Entrance Panel Size: am ~ Forced Air Furnace Radiant Baseboard or Panel Fuel Nat. Gas L.P. Oil Elec. * Solid la ^ Other p Se vice: ^ Heat Pump ~ ~9• ^ ^ ^ ^ ^ ^Other Underground ^ Boiler WaterHtg. ^ ^ ^ ^ ^ ^ Overhead ^ CentralAirConditioning ~~ ~~~ ~ . .. ~::.;:~~~~~:% ^ Other * ^ Dwelling unit will have 3 kilowatt or more installed electric space heating equip. ^ ^ Site constructed ~ '` '~~f"'~~~~~''"'`'"'""'`'`'"'"'''"'"'"'''"' Infiltration control option is: ^Full sealing Attached Detached ~ Mason of joints. ^ Blower door test. ^ Exterior ~, ~ Manufactured ^ Treated W ood wer ~ Municipal air infiltration barrier. Z ~/ Basements S ft ^ Other ^ Septic ![~«::::#~::~:~::: Cali q. . Permit No. ~L~?j?/ 1-Story ::>~:.>_»>>:.>.>:<:<<« Envelo a ©33 BTU/HR Living Area 1~ Sq. ft. p 2-Sto ^ Seasonal ', ?~'~~>~AT~i>i>i >'>>>'>>'>>>>> Infiltration ~iD 9Z .~ BTU/HR ry Other t ;.: ... Garage ?~ Sq. ft. ^ Other 1~n711. Permanen Municipal Utility ~..><T':'~~; $~. LJ I ..... r........ .'~'........ . ;; Private on-site Well $ //0 DDO. o 0 The applicant agrees to comply with the Wisconsin Unifor (ling Code and other Municipal Ordinances and with the conditions of this permit; understands that the issuance of the permit creates no leg liability, a ress implied, on the Department or Municipality; and certifies that all the above information is accurate. ~' ~~y~t.•~ SIGNATURE OF APPLICANT DATE y CONDITIONS OF APPROVAL This permit i pursuant to the following conditions. Failure to comply may result in suspension or revocation oft ' rmit or other penalty. /.l.QLs [2~~c.d Plan Review $ ~ Construction HVAC NAME Inspection $ ^ Electrical ~~~~~ Wis. Permit Seal(s) $ ~ ^ Plumbing DATE Other $ ^ Other F TOTAL $ ~ ~ CERT. NO. ~J ~Q ~BD5823(R.Mflg) ~~'jDD~ WHITE-Issuing Jurisdiction YELLOW-DILHR GREEN-Inspector PINK-Owner/Agent DATE ~~"3 `-8 ~ NAh1E ~u P-~rc~ ~' /7hOl~'` ~.~ ~ ADDRESS LOT ?,~ BLOCK ?,IARD I SUBDIV. ~ ~ II//~ ' ZONE STREET N0. ~,~~o hC.~. ~` `~~ititi ~1~:LOT D I MENS I ONS SIDEWALK EXISTING YES ~ NO BUILDING GRADE ELEVATIONS STAKES SET A- FEE: X15.00 ~~ SITE ~ N~ , ~ , 19~_BY DEPARTMENT OF PUBLIC WORKS I, the undersigned, owner or agent of grade established before excavation ha: t~~a~or.~~41 e above des commenced./ agree to have the ~2 ~3 i j DATE ~ ~ ~- ' ~~ %/ NAME C~ i~`-~h`~_~j,~~-~- ~ ADDRESS I LOT ~ BLOCK 'BARD SUBDIV. ~4c' ~ ~ ZONE STREET N0. ~` ~"~ C ~i ~~ ~ LOT D I MENS I ONS SIDEWALK EXISTING YES NO ~. BUILDING GRADE ELEVATIONS STAKES SET A~ FEE: $ /5.00 !/"- S I TE ? , 19 ~O BY /" ~ "" DEPARTMENT OF PUBLIC WORK~_. ~ I, the undersigned, owner or agent of the abo grade established before excavation has comme ~!"x~8~. property agree to have the . ~z~ 2~` City of Oshkosh 1/1/85 PARK D DEDICATI F COLLECTION RECORD z-~zo ~ . Address Owner's Name .i.~~~~~ Name of Subdivision ~.~~~~~~~-' ,, ~ 7 Lot # ~.~ Bldg. Permit # / ~ ~ 3 l No. of Units ~ Fee Required ~ /D~. ~ Fee Paid Owner's signature Inspector's signature Date _?//7 go •8ate "~/~~'0 Parks Subdivision Improvement Accts. Rec.: 362-041