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HomeMy WebLinkAbout0014326-Building_CITY OF OSHKOSH N°_ .14326 PERMIT APPLICATION AND RECORD TYPE: BLDG~TG ^ ELEC ^ PLBG ^ SIGN ^ ZONING ~ FLOOD PLAIN HEIGH'~~ -------------------------------------------------------------------- ADDRESS PLAN NO. ~ Z--[a~~7~1`. OWNER ~p ~ /~ e t C 4" J~- u~,S DES USE/NATURE OF WORK BUILDING CONTRACTOR Siz Sq. Ft.~ZS~ Z3 # Rooms ~ f3 ~~ # Stories. Height Foundation ~ Class of Const. ~- Occupancy Permit HEATING CONTRACTOR ` . e ~~ Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S ~ ~ ELECTRIC CONTRACTOR Electric Serv. New ^ Change ^ T Fixtures Switches ^ Type Receptacles PLUMBING CONTRACTOR S BT WH Disp WSoft CBasin Lav Sh DW DF -San. Sewer WC FDr SP Ur -Storm Sewer -Sink LTub -Eject SS -Water Other FEES: Valuation ISSUED BY~ In the performance of this works l agree SIGNATURE ADDRESS Paid $ _ -Date Volts Amps Circuits Park Dedication $ ~~O Final/O.P. 1c'~.~ O • $q all work pursuant to rules governing the described construction. `~ ~ D E TELEPHONE # C Z °-~~ ° 7S-F~ Department oflndustry, Labor ~ Human Relations Di i i f f il WISCONSIN UNIFORM BUILDING PERMIT APPLICATION NO. L v on o dings s Sa ety & Bu Mad son, wl s37o7 Wisconsin Statutes 101.63, 101.73 APPLICATION See /nstructfons on back of Ink co PARCEL NO. '.PERMIT REQUESTED ' .I~.STRUCTURE ^HVAC ^ ELEC ^ PLUMBING wner's Nam Mailing Address Telephone f ..- z fig h.e c` O ~ C Contractor's Name Mailing Address Telephone ~~~~~~~ L.~C~t~N ''/a, ''/a, SECTION , T N, R E or W Building Address Z Subdivision Name Lot No. Block No. Zoning District ~- of Area ~ Opp © S . ft. Setbacks Front > ~~~-ft. Rear ft. Left ft. Right l ft. 1a. !' . OJ~CT ___ 9. TYE~ B.; EEI.NaCTR~GAi. 9. H: AC Eg111PMENT 12. ~k~{I »F1GY SO URC ew ^ Addition ^ Raze ^Alteration ^ Repair ^ Mov ^ Si gle Family wo family Entran Pan Size: amp Forced Air Furnace Radiant Baseboard or Panel Fuel N t. G ~ L.P. Oil Elec. * Solid lar Other Ser ' e: ^ Heat Pump Space Htg• ^ ^ ^ ^ ^ ^ Other nderground ^ Boiler Water Htg. ^ ^ ^ ^ ^ ^ Overhead ^ Central Air Conditioning b, ~7A~AGE ' ~, '(,(j[i~~j, ~~ ], F~t~~tQATtQt~; ; ^ Other * ^ Dwellin unit will have 3 kilowatt or more installs electric space heating equip. tt h ^ Its COnStrUCte ncrete ~Q. Pt_t,~t~~~l~C.7 Infiltration control option is: ^ Full sealing ac ed Detached asOnry of joints. ^ Blower door test. ^ Exterior >~ /~~~ anufactured ^ Treated Wood Sewer unicipal air infiltration barrier. ~ Z Basements ~ S~O S ft ~ STORIES ^ Other eptic 13. H~A1` L43S .calculated} q. . ~7~~ ~-~~~ ^ 1-Story ~ ;~~~ Permit No. Envelope BTU/HR Living Area ~ Sq. ft. _ tory ^ Seasonal 7fi. WATER ! Infiltration BTU/HR Garage ~~ Sq. ft. ther rmanent O h unicipal Utility 't~. ' ~TIl1~ATEp ~~~ t er ^ private on-site Well $ ~~..~ - The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Municipal Ordinances and with the conditions of this permit; understands that tl~e issuance of the permit creates no legal I' ' ity, express or implied, the partme or 'cipality; and certifies that all the above information is accurate. SIGNATURE OF APPLICANT DATE ~ CONDITIONS OF APPROVAL This rmit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. ~ v @ r'` rcu. ISSUl1~IG ` JURISDICTIt)N ^TOWN ^ VILLAGE CITY ^ COUNTY ^ STAT ^ EPEND OF: Municipality Number of Inspection Authority © ~ G~ Municipality Number of Dwelling Location, if different - - - - - ~E~S: P~RMt~S); '1,4S11~ FS Ut~t~C#RM PL~If$IT SEAL NO. '' p~A#IT 155UEiD BY: Plan Review $ b I ti Construction ^HVAC / NAME ` nspec on $ Wis. Permit Seal(s) $ ~.~ ^ Electrical ^ Plumbing DATE Other $ TOTAL $ ^ Other c ~~ / ~ ~ CERT. NO. SBD5823(R.04/87) ~v~ WHITE-Issuing Jurisdiction YELLOW-DILHR / GREEN-Inspector PINK-Owner/Agent ZCNtQ~/I~'~iVD (J5E 0.~+PLIArA'2 G~IDG~.IST I. f~1tAL Building Psmtit ~ Zoni:~g_~ C.aofoza~ing No~rCa~~fo~iaq_ ~~ / Job Lomti~ ~ t~ Iot D~i~sion ~_ p~Y ~~ ~ ~ ~"~ Iot Asea a. o~.smv ~, ,~ r~ ar~s~oer _, Aco~cN _ Y Hu£ldiug _ Post ~ _ s,~igyli Family _ ~ _, DecK/Pat3o _ SVo P'~iSy _ eoathot~se _ Sign _ 1~sLtia-Family _ Qtitity S~ _ Poroti _ ~7. .~~~.v. ~7~ ~. i Q~ ~ _ ^ _ IOC ~ldth _ ~~ / / IOt AZSi F~OD~18~31 /- _ ,_ ~ wont ~ _ _ / ~~ side ~ (~ _ _ sip ~a a.) ~ . _ -_ y Tat Asp pmt Famil l/ _ , G~xne~ Iot ~, (speeit~y) IV. I~V~T ALTI~ITY The Planning Director, ~ ~ desa~e, aunt approvm ali plans, e~ept the ~ll+oarit~g: (1) AID*.=~ as 3 wo~rlc then the ttsa is me~o~g and wisest no a of ~ 3a psa~Qoeed. (2) Mleinterea~oe items, e:9... sdidir~9'. wia3ows, st+c. , wisen the tsss fa aattfia~g and when m cue c!~ tae is prapmed. 8~1 ~ ?n~ecta~ without regal bo the~Ealanni~ ~c~ b~ reviewed ABPRDiV~ NOT APPi~ __ Play t~ssion Actioct F~equired Variancets) Required - FlEVSF~~ BY: ~~: City of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address ~ ~ ~ T Owner's Name ~o v~ ~ P. c` Name of Subdivision Lot # ~ ~ B1 dg . Permi t # ~-~ .~ ~o No. of Units Fee Required ~O~C Fee Paid / ~'~ _ Owner's signature Inspector's signature Parks S'ubdiSrision Improvement Accts. Rec.: 362-041 NAP~1E ATE CD ,~~ ~ / 0 ADDRESS LOT ~ BLOCK T,1 SUED I V . ,,~,~z..a,rQ~~? ZONE _.,Z STREET N0. 0~~9/ o~. / e7~'._ LOT DIMENSIONS ~d~` `'~~C ,~`3-~- --~, SIDEWALK EXISTING YES NO ~ ~~ BUILDING GRADE ELEVATIONS STAKES SET AT SITE ,19_~BY FEE': $15 .00 ~~ DEPARTMENT OF PUBLIC WORKS X ~ 1, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced. h ~~~ OWNER ~~ ~ec' e ~v S C DATE PE~iMIT ~_~,~ GENERAL CONTRACTOR ADDRESS ~ ~ 9 / ~Y USE /I/i~A' ~~ i - I~i~~l~~ ~i~~ WOY1G COn9 i8 t8 O~ MASON CONTACTOR ZOfi~tE DATE INSPECTIONS FOOTIN ice] I~~ ~ ~~~~~ I~~ ^ BACKFILL .~~~ '~~~ STRUCTURE ~C~1 w_.._.~~ ~. ~~s~ ~ Z Z~ C i \ ~ ~~~