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HomeMy WebLinkAbout0047803-Buildingo _ ~_ ~ ~, N- 4 ~~3 CITY OF OSHKOSH PERMIT -APPLICATION AND RECORD TYPE: BLDG HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING -J~- FLOOD PLAIN ~._ HEIGHT -------------------------------------------------------------------- ADDRESS / _T~ ~ ~y l~ ~ ~~~ ~, PLAN NO. OWNER ~V`j~ L.JIJ"LS~~ DESIGNER USE/NATURE OF WORK~~t S r BUILDING CONTRACTOR w' r~s l 4fcy~' Size ~ ~ ~ Sq. Ft. 9 # Rooms 3 # Stories Height Foundation ~~~t ~ ~- Class of Const. ~ Occupancy Permit ~3.~e~~ HEATING CONTRACTOR ~ CQ-~ e-~ Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR C `~v~ , ~1~eS Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR ~ ~" t"f 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 $ ~ ~ ~ (, ~7~ Permit Fee Paid $ Park Dedication $~~~ ~o r ~ ISSUED BY ~ Date I ~ ~~~ 7~`Z ~ Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE Ca ~ 4'~ AGE WNER DATE ADDRESS TELEPHONE M 6/ ~ /~ 0-bZ~ ~ x~pb xppr~ soo~C~d /Ta''p n ~' 4Z~ 5~ ~ ~ ~ ~ ~~ • ~ ,, ~ N ~~ ` i` 2S' u~ Q3 •ysoxysp 30 ~EJ ay7 3ae~aoa aseaid puno~ are saraaedai~P 3[ 'paa~e~uoa u~a.~ay sararanaasur ~Cae so; a~q~suods~ you s< gso~ys~ 30 ~rJ dyi '~C[ao sasodand aauala3ai X03 P~- aq of s[ puu un~oys eaue aye 8u~aa;;e ~arnos ~ylo puti sao~3o alels pue ,Uunoa ~~a snouen u~ pa~eao~ e~ep P~ uopeawo3u~ sp.~oaar 3o ao~e~idiuoa a s< g~kwp ~,I, •auo se p;,sn aq o; papua~ui iou s< pue ~Cantns e Boa dew papioaai ,C~~e3a~ a rayiiaa s< dear scyy ZONING/LAND USE COMPLIANCE CHECKLIST JOB LOCATION ZONING. ~ ~ _~ PROPERTY OWNER/CONTRACTOR: ~v 5 L~. C ~,,, ~~- , CONSTRUCTION DATA: ___~ New, Construction Addition Alteration TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) _~~ a~,ow~.~a~ COMPLIANCE CHECKLIST DEFICIENT Use Lot Width Lot Area Lot Area Per Family Floodplain Front Yard Front Yard Side Street Rear Yard Side Yards Building Area Parking Standards Off-Street Loading Standards Vision Clearance Transitional Yard Standards Landscape Standards Height Conditions of Approval Compliance with P.C. or BZA Conditions of Approval Signage Standards Drainage Plan REVIEW AUTHORITY '. As per Section 30-5 Enforcement of the City' Zoning Ordinance, the Director of Community Development, or designee, must approval 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. ~~ APPROVED Plan Commission Action Required DENIED Variance(s) Required COMMENTS REVIEWED dY: ~ ,~ DATE: l D 1J`7--`1S Wisconsin Department of Industry, WISCONSIN UNIFORM BUILDING Application No. Labor and Hurnan Relations Safety and Buildings Division PERMIT APPLICATION. 7 P.O. Box 7969 (See instructions on back of pink copy) Parcel No. Madison, Wf 53707 The information you provide ma be used by other government agency Wi nsin t t 1 1.6 1 1.73 pro rams (Privac Law, s. 15.04 ~) (m)J. ,., :;~~~,:~.~~U~T, ,; ............... :; .. n r ^ o ^ VAC ^ Elec ^ Plbg ^ Erosion ^ Other: Own Name Mailing Address Telephone No. a7~0 ( ) 3/- Co ractor's Name: [] Con lec ^HVAC ^ Plbg idCert # Mailing Address Telephone No. ( ) Co actor's Name• Con ^ Elec VAC ^ Plbg iUCert # Mailing Address Telephone No. ( ) Co act is Nam ^ Con lec HVAC Ibg idCert # Mailing Address Telephone No. Contractor's Name: ^ Con Elec ^HVAC ^ Plbg ic/Cert # Mailing Address Telephone No. ( ) .:....::::::::.::::::.:. .:...... : Lot Area :>:::: ~.:; ~ •.:•::;:~: Sq. ft. 1/4, t/4, Section , T N, R E (or) W • Building Ad ss ~ Subdivi ion Na e - Lot No. Block No. /o~ 30 Zoning District(s) Zoning Permit No. Front Rear Le Right Setbacks ' f o?~' ft. ~7 ~ ft: ~'(o ~ ft r . 7 ' ft. ~ . ................................... ..............CE1P~#~t~Y:;:; :::>~I.:;::~i..~C):'~..... :.~.::~~r!~.E. .:I~"II~E'!'.::::.:: :.. ~...:. . . New ^ Repair ^ Alteration ^ Raze Ingle Family ^ Two Family Entrance Panel Size: (Q C~ amp orced Air Furnace ^ Radiant Baseboard or P n l Fuel Nat L_ P Oil Elec Solid Solar ^ Additi a e Gas ' on ^ Move ^ Garage Ser ice: u ^ Heat Pump S ace Ht ^ Other {print): nderground ^ Boiler p g ^ ^ ^ ^ ^ r ^ Overhead ^ Central Air Conditioning Water Htg ^ ^ ^ ^ ^ ^ ^ Othe ;. ^ Other * ^ Dwelling unit will have 3 kilowatt or :..:... .:;:::-:;.: , ~ .ltd. N>: ... more installed electric space heating equip. iteConstructed oncrete ' •" • •' ' ~' ••• •' •• ••""•' "'• ~~+;~!~...~$~~~<''>`'>?'>.?~»<>>`~ Infiltration control o ti n i : F II I' ..... .. .. • ~~~~ ~- ^ Manufactured ^ Masonry ••~ ~ •~~ • ••• P o s ^ u sea ing of oints_ BI r >~<>•:.' . owe door test. E ri r '~~` . ~ xte o ........................................~~>~<~>?> ^Treated Wood Sew r 1 ^ ^ >^ ~ ~^ ~ ~ ••~••~••••• air infiltration barrier. Unfinished Basement © S . ft. `~i' >' ~~~~>>::>:~'>::::>.<•':'. ^Other unicipal :...;:::;,.:.:...,::<:»::::>::»::»»><»: Se tic :>:«'>:~':'~3'1°1~'•.1P..~ . '» ;<.:.:::...~::::.::::: >:>:: ,. ::;:: . Livin Area ~ :.......::•;:~;;;:<::::::•::;•;:•>::;.; Permit No. g ~ Sq. ft. y ^ S sonal Envelope BTU/HR ^ 2-Stor . . • >'~~ts :.::.:.:• ...... ... .... .... Infiltration BTU/HR ^ Other ermanent ............. ~k'>:`>~~»#?»>~~:'>:`z': Garage ~ Sq- ft. unici al Utilit P Y ^ Plus Basement ^ Private On-Site Well The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the issuance of the permit creates no legal liability, express or imp~lied_, on t epartment or municipality; and certifies that all the above information is accurate. APPLICANT'S SIGNATURE //~~L ~~~jfL DATE SIGNED PROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. n~w~r tCtYSs~lr ~c.v~-kt',"11 < 1~n ~ ~~ t ~,.~ _ ^ Town ^ Village ^~.~ity ^ County ^ State of: Municipalit Number of Dwellin• Location: Plan Review $~O onstrudion *^~~~ Inspection $ ^ VAC Name ,J 1 p- l'r•,•v., ~ /~ L.,,L, Wis. Permit Seal $ ~- ^ Electrical SI Other $ Plumbing Date S •~P~~"~~ Total $ ~ sion ~ ~ L" "' Cert. No. ~ 13 ~~-~~~~ v~- ~~~~~~ wn~ ~ t - ~ssumg Junso~tt~On YtLLpW - DILHR GREEN -Inspector PINK -Owner/Agent City Of Oshkosh ~/~/85 PARKLAND DEDICATION FEE COLLECTION RECOP.D Address 1 f~~1 ~ 1 ,,,~ ~.~-L . ~l ~~ . Owners Name J1~ Name of Subdivision Lot ~ ~ ~ ~ v - Bldg. Permit # ~-/~8~ No. of Units Fee Required ~~ Cj Fee Paid ` d ~1 Owner's signature , Date lid/ZD ~s~ Inspector's signature ~1, Oate /~-,~j~ ~~~ Parks Subdivision Improvement Accts. Rpc.: 362-041 ~~~ o~ ~"~~~~~ a4: aney o1 aaJ6,~ f,~JadeJ ' Psouewu,o~ sey uol~eneoxe a~o~eq payg, ~ c¢~.sa BDaJb as°!1osPA anooe ay.A to .~ua6e Jo JauMO •pau6lsJapun eye ~I `N Al 011?~ic+ ~0 1P~~3y,~l~+ye'3C r!1/.lE ---- Sb61` g/ p/ 3J ~Cn~ Sr D JOISM3wIG 1C~ 3NOZ ~,i x~o-18 SS3b00~ ( - ~ ~ 31bC 00'Sltc33~ I S lb 135 53N~+1S SNO i lbh3l3 3012 JN I Q1 i t~8 JN I1S I X3 N~ b'!'R3p I S 531 • t 'ON ~t ,~, ,~ ~ ' A 108f1S C~ 1 lOl t t~-~ _ J ~".' ~ ~ t'~ 3Wb~N 133~+1S OWNER ~~JS~~ DATE ~ ~ --a~~S PERMST #~~_ GENERAL CONTRACTOR ADDRESS ~ ~`1 S ~~rn ~ ~ ~C ~ ~ ~ USE 1.1 ?~'~ WoYk consists of S ~'~'ztit.~. MASON .CONTRACTOR ZONE Width of lot a+ O W a m a Front of lot DATE 0 o h' i INSPECTIONS RF.HiARKS ~ d~ ~ ~~ 1~) n .. 11G~V~~~k 1r t~ -~ ~~6 •APt ,S~Yn,,.e,c', `nom tz. <.. ~ c.l l r~ L' ~-t- S'Yx1rv ~ ~. 1..0~.~ Y~ ~ ~ ~ ~ 1~i~ ADDRESS 4~ ~~ Ana ~- ,nom 2~3k..1 ~ ,~J,r-•~-~S ~ Seer ~~~ H