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HomeMy WebLinkAbout0016252-Building~ CITY OF OSHKOSH N° 16252 `' PERMIT -APPLICATION AND RECORD TYPE: BLDG~HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAT-HEIGHTy~ ADDRESS ~- ~, ~ PLAN NO. OWNER ~~~ ~L° ~ ~° G1~ °~.= iJ-~ ~ DESIGNER USE/NATURE OF WORK BUILDING Siz `~ Sq. Ft. ~~ ~ v ~ # Rooms f - , ` # Stories Height Foundation ' Class of Const. ~ Occupancy Permit HEATING CONTRACTOR Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR ~ -c~-w` ~`c Electric Serv. New ^ Change ^ Temp ^ ', Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR ~ r~., w-~' BT WH Disp 'I ~ WSoft CBasin Lav Sh DW DF -San. Sewer - WC FDr SP I Ur Storm Sewer -Sink LTub Eject SS Water Other FEES: Valuatio $ ~ Pe Fee Paid $ ° -~ ~ Park Dedication $ r ~~ ISSUED BY Date Final/O.P. ~' ~~- ~b In the performance 9i 9~" work I ago perform all work pursuant to rules governing the described construction. AGENT/OWNER ' ~ .~ E ~~,,~ri ~)'I ~ ~~ TELEPHONE # Department oflndustry, Labor & Human Relations Di i i f S f 8 B ildi WISCONSIN UNIFORM BUILDING PERMIT APPLICATION NO. v s on o a ety ngs u Mad son, wl 53707 Wisconsin Statutes 101.63, 101.73 APPLICATION See /nstructlons on back of ink Co PARCEL NO. 'PERMIT REQUESTERSTRUCTURE ^HVAC ^ ELEC ^ PLUMBING Owner's Name Mailing Address Telephone 1~0 ~ tc~ Contractor's Name Mailing Address Telephone 'PR#~IECT ~OC/~~Qh1 ; ''/s, ''/a, SECTION , T N, R E or W Building Address t1- Subdivision Name e Lot No. Block No. Zoning District Lot Ar f . n. Setbacks Front C7 n. Rear ~ n. Len ~ n. Righ / ~ ~ n. 1a. PRt~JE~'> 3. 'i'YpE fi. '~k.~C7R~CAl" ' 9. HVAC EQU-PM~NT i2 ~N ERGYSOtJWC~ ew ^ Addition ^ Raze Alteration ^ Repair ^ Move Single Family Two family Entran e P Size amp orced Air Furnace adiant Baseboard or Panel Fuel Nat. s L.P. Oil Elec. * Solid lar ^ Other . Service: ^ Heat Pump Space Htg. ^ ^ ^ ^ ^ ^ Other nderground ^ Boiler Water Htg. ^ ^ ^ ^ ^ Overhead ^ Central Air Conditioning ~b G~~G~ - ~ ~,'~~ 7« F'~~j~QATtQt~];; ^ Other * ^ Dwelli unit will have 3 kilowatt or more install electric space heating equip h d ^ D tt t h d to COnStruCted COnCrete '~Q. PLUM$,fMC~i . Infiltration control option is: ^ Full sealing ac e e ac e ^ Masonry of joints. ^ Blower door test. ^ Exterior AAA Manufactured ^ Treated Wood Se r Municipal air infiltration barrier. Basements ~ S n ~ S'>F'iI~IRIES': ^other ^ septic i3,.}fEA7>LO$S Calculated) q. . Q ^ 1-Story - ~ ~ Permlt No tt ,, Envelope ~Th~© BTU/HR O S Living Area q• n• -Story ^ Seasonal 1~. WA~`Ei~ ' ! Infiltration BTU/HR Garage 7~~g Sq. n. ^ Other ermanent ^ O h unicipal Utility ~:4, '~,gT~~A~D EO~~ t er ^ Private on-site Well $ ^"' The applicant agrees to comply with the Wisconsi Un' rm Dwelling and other u icipal Ordinances and with the conditions of this permit; understands that the issuance of the permit creates no legal ,express plied, on th artment or Municipality; and certifies that a the ab a information is accurate. SIGNATURE OF APPLICAN DATE CONDITIONS OF APPROVAL This p is issued p uant to the following conditions. Failure to comply ma result in suspension or rev ca ion of this per t or other penalty. ~ s I t y - t ~V /"' xlz < < .G - f Z ~ ~~~~1~11~'s JURISDICTION ^ TOWN ^ VILLAGE TY ^ COUNTY ^ STATE r],)ND~P,END OF: ~ Municipality Number of Inspection Authority //'' Q- ~~SQ Municipality Number of Dwelling Location, if different - - - - - - ~S: P~RIYtS) E liY6S; Ut~t~f3RM PI$RRiIiT SEAL NO. _.. REAMII` t88U~D BY: Plan Review $ _~ Inspection $ Wis. Permit Seal(s) $ ~ Construction AC ^ Electrical ^ Plumbing NAME DATE Other $ TOTAL $ ^ Other ~~ CERT. NO. 1, SBD5823(R.04/87) WHI(T'E~-ISSUingJurisdiction YELLOW-DILHR GREEN-Inspector PINK-Owner/Agent ~C ~PL`I~ Revised: 8/89 JOB LOCATION: ZONING/LAND USE COMPLIANCE CHECKLIST r PROPERTY OWNER/CONTRACTOR: CONSTRUCTION DATA: NEW CONSTRUCTION ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (~e~ fence, pool, sign, deck, etc.) ZONING: COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT ', DEFICIENCY/COMMENTS (.~ Use t/~ Lot Width '' ~r/ Lot Area ~I ~~ Floodplain ~~~~~ ~ Front Yard Side Street (fruit yard) ~ Rear Yard ' ~ Side Yard (R) Side Yard (L) ' L' ~ Parking Spaces ~~~, `-' Building Area ~ Lot Area Per Family ~i~-~ Corner Lot Landscaping Transitional Yardl Off-Street Loading Vision Clearance Height REVIEW AUTHORITY: ~p~O ~~~- APPROVED. Plan Commission Action Required Variance(s) Req.uire~d /~ The Director of Community Development, or designee, must pprove 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. REVIEWED BY: DENIED DATE: ~~ City o€ Oshkosh 1/1/P5 Address Owners Name ~,,, ~~ ~_ ~~s~ Name of Subdivision ~- c-c~.c e / o Lot # /~ B1 dg . Permi t # !~ ~. ~ 2. No. of Units Fee Required ~© fl Fee Paid /0 Owner's signature Inspector's signature PARKLAND DEDICATION FEE COLLECTION RECORD Date Date f 7 Parks Subdivision Improvement Accts. Rec.: 362-041 NAME LOT ~ J~ n(~- nn SUBDIV. _~J~r~~'oXG~tX STREET N0. a-3 8 ~ ~°~~`~ e SIDEWALK EXISTING YES DATE JO's ~ -~9 ADDRESS ~ o~ S BLOCK 'd ZONE - ~ LOT DIMENSIONS i Jr6 I ~- ~ ~~~ NO ~' BUILDING GRADE ELEVATIONS STAKES SET AT SITE ~ ,19BY_~ FEE: x`15.00 DEPARTMENT OF PUBLIC WGRKS /~ t ~ -. I, the undersigned, owner or agent of the above described pr perty agree to have the grade established before excavation has commen~edO ~ /~ ~/ ~3 Z U~ a n ~o v} r tR 0 ~- i ~ I ~~ ~_ ~~ ~_ '~, ~ RON LEICFITFI BUILDERS 326 N. Sawyer i3br Oshkosh, Wiscon Phone: 233-53 ~~. ~rrxee~~.Komes ~ CUSTOM DESIGNED -QUALITY HOMES _~ -~- i ~ `^`' 1 t 1 Z j--- t~ ~ p~ .,, ~'d , OWNER ~~ c~ l~ ~ c`C` G~O~-~ u.s~ DATE PERMIT # GENERAL CONTRACTOR MASON CONTF~PiCTOR width of lot ADDRESS ~3 cQ'~ ~ a ~y '~_D~ USE t°1.~ ~ ~( WoYk cons is is of ZONE .~ 0 w 0 ,~ a m A ?ront of lot DATE INSPECTIONS RKS ~~~ .3' MAILItvC3 AD'' ~!SSs