HomeMy WebLinkAbout0055696-Building~~
OSHKOSH
ON THE WATER
Job Address 565 GOLDEN IRIS DR
Designer
Owner DUWAYNE JACOBSON
Contractor DUWAYNE JACOBSON. BUILDER
No 0055696
Create Date 11 /14/96
Category 110 -New Single Family Plan 65-196-1196
Type Building Sign Canopy Fence Raze
Zoning R1 Class of Const: 8 Size IRREG
Unfinished/Basement 440 Sq. Ft. Rooms 6 Height 22 Ft. Projection
FinishedlLiving 1600 Sq. Ft. Bedrooms 3 Stories Quad-level Canopies
Garage 484 Sq. Ft. Baths 2 Signs
Foundation
CITY OF OSHKOSH
BUILDING PERMIT -APPLICATION AND RECORD
Poured Concrete ~ Floating Slab (~ Pier ~ Other
Concrete Block ~ Post Q Treated Wood
Occupancy Permit Required
Park Dedication Required
UseMature
of Work
Flood Plain No Height Permit Not Required
# Dwelling Units 1 # Structures 1
NEW SFR W/ ATTACHED GARAGE- LOWER LEVEL UNFINISHED
HVAC Contractor Plumbing Contra
Electric Contractor
7; ~
Fees: Valuation X61,000.00 Permit Fee Paid $267.50 ~ ^~~{~ ~nL .oY Park Dedication
Issued By: Q~ x Date 11/15/96 Final/O.P.
Permit Veideri (~ ~/
f-+ - - - - --- i vi Q
In the pertormance oft ' rk I agre pertorm a pursuant to rules governing the described construction.
Signature
Date 1<
Agent/Owner
Address OSHKOSH WI 54901 - 0000 Telephone Number
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GATE
N/~'dE ~~ev~ / ~ ~ AOORESS
LOT ~ BLCCK t,l,~Fsl~
SU80 ~P S ZGNE
STREET NO. S -- cLr, LOT OIMENSIGNS
S I OEYrALK Ex I ST! NG YES ~ NO
BUILDING GRAOE ELE~/ATIONS STAKES SET AT SITE 3 ,I9~gY ,L~IJ
FEE:
X15.00
DEPARTS`-"•t~:T OF ~~~o L I C ' GriKS
I, the undersigned, owner or agent of the above dascribeC praperty agree ro have `he
grade estaDiished before excavation has cormmenced.
~~ I
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations
Safety and Buildings Division BUILDING PERMIT 0055696
P.O. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
Wisconsin Statues 101.63, 101.73
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~ ®Constr ^HVAC ^ Elec ^ Plbg ®Erosion ^ Other:
Owners
Name Mailing Address Telephone No.
DUWAYNE JACOBSON Oshkosh WI 54901 -0000
on ra or: Con ~ Elec ~ HVAC Plbg Lic/Cert # Mailing Address Telephone No.
DUWAYNE JACOBSON, BUILDER 1042 PIERCE AVENUE OSHKOSH WI 54901 -0000 414-231-3389
on rac or: Con Elec HVAC Plbg Lic/Cert # ai ing ress a ep one o.
ontrac or: Con Elec HVAC Plbg Lic/Cert # ai mg ress a ep one o.
on rac or: Con Elec HVAC Plbg LiclCert # ai ing ress a ep one o.
':+.~'~:,w.~!'" o rea S . ft. 1/4, 1/4,Section ,T N,R E(or)W
Building Address Subdivision Name Lot No. Block No.
565 GOLDEN IRIS DR
Zoning District(s) Zoning Permit No. Front Rear Left Right
Setbacks ft. ft. ft ft.
::
•. .... ..
® New 0 Repair Single Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. Solid Solar
Alteration ~ Raze Two Family Size: 22 amp Radiant Baseboard or Panel Gas
Addition ~ Move Garage Service: Heat Pump Space Htg ® ^ ^ ^ ^ ^
Other (print): Overhead Boiler Water Htg ® ^ ^ ^ ^ ^
Other Underground
• Central Air Conditioning Dwelling unit will have 3 kilowatt or
' `'.'~1':':~! :tl~ • .••
: Other more installed electric space heating equip.
~~If:l~':(
~ Site Constructed Concrete
• ~~~'~~~~'
Infiltration control option is: ®Full sealing
Unfinished ^ Manufactured Masonary Sewer of joints. ^ Blower door test. ^ Exterior
Basement 440 Sq. ft. ' ;~; :'.' "' " Treated Wood ®Municipal air infiltration barrier.
Living Area 1600 Sq. ft.
1-Story Other
... Se tic
^ P ~
.,~t':~`:~fi•,,:,„~,;~:.fr•`,...::::..::....:.:':
Garage 484 Sq
ft ~ 2-Story '.•Seasonal Permit No. Envelope 22500 BTU/HR
.
. ® Other ~~~ Infiltration 13100 BTU/HR
®Permanent ; ;
Quad-level Municipal Utility ~~~1~`
€~
:
® Plus Baseme
t ^ Other P
i
t
O
Slt
W
ll ........
.
n r
va
e
n-
e
e $72,000.00
The applicant agrees to comply wlth all applicable codes, statues and ordinances and with the conditions of this permlt, 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.
APPLICANT'S SIGNATURE DATE SIGNED
APPROVAL CONDITIONS This permit is issued pursuant to the following condtions. Failure to comply may result in suspension or
revocation of this permit or other penalty
KING BEAM SHALL BE PROPERLY SIZED/ TRUSS PLANS SHALL BE SUBMITTED
^ Town ^ Village ®City ^ County ^ State of: Municipality Number of Dwelling Location:
~.~~~.' '~ City Of Oshkosh 7 0- 2 6 6
:.
Plan Review $40.00 Construction
Inspection HVAC Name ALLYN DANNHOFF
Wis. PermltSeal $80.00 Electrical
Plumbing Date 11/14/96
otner
Erosion
Total $70.00 185881 Celt. No. 4340
aou-~at.s (rc. uilaz)
PARKLAND DEDICATI N FE
OSHKOSH O E COLLECTION RECORD
ON THE WATER
Job Address 3770 HARVEST DR
Name DUWAYNE JACOBSON
Address
Subdivision
Building Permit Number 0055697
Date 11/15/96
Oshkosh W I 54901
Lot
Number of Dwelling UnRs 1 Number of Structures 1
Fee Required $100.00 Fee Paid
Owner's Signature Date
Inspector's Sign Date
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