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HomeMy WebLinkAbout0018284-Building.~ CITY OF OSHKOSH N°_ 18284 `' PERMIT -APPLICATION AND RECORD l`YPE: BLDG~HTG ^ ELEC ^ PLBC~- SIGN ^ ZONING ~~ FLOOD PLAINEIGHT~~ -------------------------------------------------------------y----/q- ADDRESS ~ 3 4- PLAN NO. ~~_ `~' r ~/~ OWNER O!~ i~..e t C c~ ~ .,$ DES USE/NATURE OF WORK BUILDING CONTRACTOR ~~ ~`'~-~ °~ ~ SizE`'~ Sq. Ft. Z7sZ -S # Rooms ~`f" # Stories ~ Height -}+ f Foundation Class of Const. ~ Occupancy Permit _~ HEATING CONTRACTOR Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR ~ ~' Gt- Electric Serv. New ^ Change ^ T~ Fixtures Switches ^ Type Receptacles Volts Amps Circuits PLUMBING CONTRACTOR ~ ~ BT WH Lav Sh WC FDr -Sink LTub Other Disp DW SP Eject WSoft DF Ur SS CBasin -San. Sewer_ -Storm Sewer Water FEES: Valuation ©~ mit Fee Paid $ S~ Park Dedication $ 1~ ISSUED BY Date r Final/O.P. ~ a ~~~~ In the performance of Jails work I SIGNATU ADDRESS to perform all work pursuant to rules governing the described construction. AGENT/OWNER v DATE TELEPHONE # State of Wisconsin Department of Industry, Labor & Human Relations WISCONSIN UNIFORM BUILDING PERMIT Q. g APPLICATION NO. V ~ C~ Division of Safety 8 Buildings Madison, wl 53707 Wisconsin Statutes 101.63, 101.73 APPLICATION See /nstructions on back of Ink CO PARCEL NO. PERMIT REQUESTED ' STRUCTURE ^HVAC ^ ELEC ^ PLUMBING wner's Name Mailing Address Telephone e ~ pl.W{ Co tractor's Name Mailing Address Telephone ~ r' ss 3~s r- ~ --S ~R#~J~Gfi i.4CATtQN ~/a, ~/a, SECTION , T N, R E or W Building Address Subdivision Name ~ ~ Lot Nfo. 6 Block No. Zoning District Lo rea s . n. Setbacks Front n. Rear .~.. ~-~ n. Left n. Right ~ 7/ n. 1a. P~OJ~CT 3. 1'YPIE B. 't~LEC~fi~CA~. ' 9. HVAC ~QUIPAA.~NT i2. ;.;EN ERGY SOt1RCtr ew ^ Addition ^ Raze ^ M ^Alt ti ^ R i .Single Family famil ^ T Entra a Panel Size am Forced Air Furnace Radiant Baseboard or Panel Fuel Nat. C' L. P. Oil Elec. * lid lar r ove era on epa wo y ^ Other p Service: ^ Heat Pump Space Htg. ^ ^ ^ ^ ^ ^ Other nderground ^ filer Water Htg. ^ ^ ^ ^ ^ ^ Overhead Central Air Conditioning ^ jb, (a~#~AGE _ ~ („'Q~~'f ~~ 7. ~at~~tQATIf~N_, ^ Other Dwelling unit will have 3 kilowatt or * more installed electric space heating equip. e COnstrUCte Concrete ~Q. R~.ililMf~ING Infiltration control option is: ^ Full sealing ttached ^ Detached ^ Masonry of 'oints. ^ Blower door test. ^ Exterior ~ ''~. IEA anufactured ^ Treated Wood ewer unlClpal air infiltration barrier. Z7~Z ~1$~`I~~'' ^ Other ^ Septic i3'REA-'~';;I,.f~~S;; Ga~.fculatfed} Basements Sq. ft. ^ 1 to ~ ~ Permit No. Envelope ~ G ~ BTU/HR Living Ar Sq. ft. ry -Story ^ Seasonal 11 ..;~~~IR~ ' Infiltration BTU/HR Garage ~ Sq. ft. ^ Other ermanent unicipal Utility 1$.> ~STIMA't'~C COST ^ Other ^ private on-site Well ..~- The applicant agrees to comply with the Wiscon ' orm Dwellin de and other Muni 'pal Ordinances and with the conditions of this permit; understands that the issuance of the permit creates no leg I Ility, express plied, on the De ment or Municipality; and certifies that a I the above information is accurate. SIGNATURE OF APPLICA DATE CONDITIONS OF APPROVAL This per is issued pursuan o the following conditions. Failure to co ly y result in suspension or rev n of this permit or er penalty. ~~ r1 Coe~c CJ Zl ~- G1it_ Q ~ ~ ~' V i~ Ce ~ ~m ~ ~' !` a ~ co ~/ G1 t .SsY c ~~° T r tie omr Q~ J I`L ( k L ~f Q /~ m h. O` O o^-' ~ f O ~ O`er f~ e/ f ~. e a-f' ~ ve ~ a e c 'ISSN' ~+ ~TURISDICT~ON ^TOWN ^ VILLAGE ITY COUNTY ^OFATE `IN Ep PENgENT k~s,(,~ Munlcipality Number of Ins~tionAuthSt4 p _ ~- Municipality Number of Dwelling Location, if different -- - - - FEES: P~EtM~S}. >Cr~~E WFS. iINIFQRM PL#~IVIIT '' SI`AL (I[O. PER#IT ISSUEb BY: Plan Review $ ~~V Construction HVAC NAME ~~ Inspection $ ~ Wis. Permit Seal(s) $ ~ Electrical ^ Plumbing DATE Other $ TOTAL $ ~ ^ Other ~--~ f ~~ G~ ~ ~/ CERT. NO. "T ~~~ SBD5823(R.04/87) WHITE-Issuing Jurisdiction YELLOW-DILHR GREEN-Inspector PINK-Owner/Agent Revised: 8/89 ZONING/LAND USE COMPLIANCE CHECKLIST JOB LOCATION: Z ~ ~"D ~C~~,. ('~ ZONING: -~,~ PROPERTY OWNER/CONTRACTOR: ,~~rt h~P~c ~~~ ~~ CONSTRUCTION DATA: NEW CONSTRUCTIgV ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSSTRUCTION: (i.e. fence pool, sign, deck, etc.) COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT DEFICIENCY/COMMENT5 ~" Use ~% lot Width ~.- Lot Area Floodplain ~- Front Yard Side Street (front yard) ,,. Rear Yard ~ Side Yard (R) ~ Side Yard. (L) L-- Parking Spaces ~' _ Building Area ~ Lot Area Per Family ,r~/ Corner Lot Landscaping Transitional Yard Off-Street Loading Vision Clearance ~ Height 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. ~~ APPROVED DENIED Plan Commission Action equired Variance(s) Required ~ ~ _ , REVIEWED BY: DATE : 7~/c7 City of Oshkosh 1/1/5 PARKLAND DEDICATION FEE COLLECTION RECORD Address Z3 ~-~ ~Q~v Owner's Name ~ ~~ r cG~ `~ S,S Name of Subdivision ~-~.~e~ ~.^,~ Lot # ~( Bldg. Permit # ~ ~Z8 7 No. of Units l Fee Required /~ Fee Paid Owner's signature Inspector's signature Date ~ _ ~ ~ ~'D Parks Subdivision Improvement Accts. Rec.: 362-041 DATE `7` ~o~ ~-'90 NAME ADDRESS LOT // BLOCK ~aaaD ~ ___ SUED I V . tr.~.e~c.~NE ~ / STREET NO . ~ ~ ~o ~G~ ~-~-`' LOT DIMENSIONS ~~ SIDEWALK EXISTING YES Q NO BUILDING GRADE ELEVATIONS STAKES SET AT SITE 2 ,19~_BY ~tJ FEE: ~ls •00 " ~- DEPARTMENT OF PUBLIC WORKS I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced. ~~f~~ld~ ~Zz h ~_ f r c~t' ~,~