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HomeMy WebLinkAbout0029240-BuildingCITY OF OSHKOSH N°_ 29240 PERMIT -APPLICATION AND RECORD TYPE: BLDG ~ HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING L~ FLOOD PLAIN HEIGHT -------------------------------------------------------------------- ADDRESS ~ 7O ~ 1 ~/( PLAN NO~.3 g L ~ f'o ~ LK~ OWNE DESIGNER USE/NATURE OF WORK / /~~~ ~ =.~~t BUILDING CONTRACTORS/• ~ ~ ~„GG~~-~-~ Size Sq. Ft. ~ Z ~O # Rooms 3 ~ # StoGries Height ~ ~ Foundation ~.~,z~ • Class of Const. a Occupancy Permit ~~~ HEATING CONTRACTOR e ~7 Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR /~y- Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR 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 $ O ISSUED BY . O O Permit Fee Paid $ /O J ' ~ ~ Park Dedication $ Date ~ X7'`9 ~ Final/O.P. a5 ~o~ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. ~. SIGNATURE _.__~ . ~Q "~~~J~ A NT/OWNER DATE ADDRESS _ [ / TELEPHONE # ~,~ . Z.v ?i ~ ~ /~ l (o ~ Revised: 8/~ ZONING/LAND USE COMPLIANCE CHECKLIST ~/ JOB LOCATION: 7'Z7 ~~P.e~~-~--~ ~/~ . ZONING: PROPERTY OWNER/CONTRACTOR: ~,~ ~ ~a-C.Cc~ ~~ CONSTRUCTION DATA: /NEW CONSTRUCTI{N ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.) COMPLIANCE CHECKLIST (Check only those applicable) DEFICIENT DEFICIENCY/COMMENTS _ Use ---- Lot Width ___ Lot Area Floodplain Front Yard Side Street (front yard) _ Rear Yard Side Yard (R) Side Yard (L) Parking Spaces Building Area ' Lot Area Per Family ___ 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. ~~PPROVED Plan Commission Action Required Variance(s) REVIEWED BY DENIED ~3 9z4(ogz~ State of Wisconsin Department oflndustry, WISCONSIN UNIFORM Labor 8 Human Relations Division of Safety a Buildings BUILDING PERMIT APPLICATION NO. ~ 7 Z ~d Mad sgon, wl 537W APPLICATION Wisconsin Statutes 101.63, 101.73 $ee /ng/~//png pn ~ pj. nk PARCEL NO. iPEI~N1`~1E19~TE0 CONSTRUCTION ^HVAC ^ ELEC ^ PLUMBING ^ OTHER: Owner's Name Mailing Address Telephone O ~ 3 ~~ Contractors ame Mailing Addr Telephone - ~i!. 2 /7O filf. Go . ~-s/, 4,c~~i~=e~~' c.{z!o - 392- ~ >::»:: L of Area ~F.£'rT ~.OC~N > :...............::[:::::::.....:::::; Sq. ft. Building Address ~ '/s %a SECTION , T N, R E or W Subdivision Name Lot No. Block No. ~/1 - . 2v % /~N 2 lib c~ ~-S ~f1~6 Zoning Distric (s) Zoning Permit No. Front Rear Left Right ~ setbaa~s /off n 3~- ft ~~_ ~~ ;..... ~: .::........:.. . . ~ .::::.::>::>:: :;1.~.>;:~~ERQ~f:~O ~. UAC~ ~ew ^ Repair Single Family LJ Alteration ^ Raze ^ Two family Entrance Panel Size: ~_ amp ::::. Rorced Air Furnace Radiant Baseboard or Panel Fuel Nat. L.P. Gas Oil Elec. Solid lar ^Addition ^ Move ^ Garage Service: ^ HeatPump Htg. ^ ^ ^ ^ ^ ^ Other Underground ^ Boiler Water ^ ^ ^ ^ ^ O h d ^ ver ea Central Air Conditioning ^ Other '~ ~~~~ ~r~~ ,,m~ilt~t. lfr::>~~~1 ~ai!«::: ^ Other ' ^ Dwelling unit will have 3 kilowatt or more installed electri h ti i ..,...,_, ....................___ _ ....... ite con r st ucted Concrete :.... ::. . [.;.:.;s>:<::.:..::....~''s#;::;E<<'>«>.. c space ea ng equ p. Infiltration control o lion is: ^Full sealin P 9 i~. l~~F~ ~~p .;. >.'; ^ Manufactured ~Onn' er of joints. ^ Blower door test. ^ Exterior ^ Treated Wood Municipal air infiltration barrier. ^ Other ,;..... 5~ '&TIF~`: €:;.> ^ Septic 7~'::H~k;~''#~$'~`:. Galc~la~tf~d~ Unfinished Basemen Sq. ft. Permit No. ..:.:: ~`'j., ~ O 1-Story ~~~•~:'`?'` > ~> ::.:: ~::::: Envelo e Living Area Sq. ft. ,..::: ..:::::::::.:.:::.::::::.:::.:::::..::: P BTU/HR 2-Story Seasonal '~"~~':~`,t~~>><_>>>??>> ,'2i G ... ......... Infiltration BTU/HR 1 ^ Other ermanent Garage Sq. ft. Municipal Utility '~ ~'~';;~;;~ ~.~5'h Other Private on-site Well ~ ^ Plus basement $ ? Z O©O. ~ 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 implied, on the Department or Municipality; and certifies that all the above information is accurate. SIGNATURE OF APPLICANT onTE CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. c '1 ,..L ~_ ...~ ^TOWN I~Hi!LAGE .CITY ^ COUNTY Municipality Number of Municipality Number of Dwelling ^ STATE ^ IN E END Inspection Authority Location, if different Plan Review $ • O ~ Construction HVAC Inspection . $ ~ `o ~ I O ~ ~~' NAME Z ^ Electrical /' Wis. Permit Seal, $ ^ Plumbing DATE ~ 7 '7 Other $ ^ Other TOTAL $ c7 CERT. NO. ~S •~ ~ •.,....~..~„•.,,..,r nrni~-issumguunsaic[ion YELLOW-DILHR GREEN-Inspector PINK-Owner/Agent °`~ ~~~ ~ GATE i~ NAME ~., ~ ~? . ~J,~'aG(~ , AODRES S LOT ~,de,~ , 20 1 /~,v yZ l6 r BLGCK _ r ~ dAAD STREET NO . 7 7 D ~~ ~ (~~,~., ~,_ G~f~ LGT D I,~ENS I GrdS SIDEWALK EXISTING YES ~ NO BUILDING G,'~AOE ELEVATIGNS STAKES SET AT SITE ~ ,19 g ~ EY FEE :-$~~pp X15,00 DE. T~• E?~T OF PUB l (C WCr~KS I, the undersigned, owner or agent or the above described property agree ro have the grade estaaiished before excavation has commenced. '~~~`'^~ r.~, ~~i.aJ~~r~9 ~~ u~y.__