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Home My WebLink About0023230-Building~: ~ CITY OF OSHKOSH N~ 23230 PERMIT -APPLICATION AND RECORD _ cl / TYPE: BLDG ~$( HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING ~ 3 FLOOD PLAIN HEIGHT °~ 7 ADDRESS ~~ ~/ ! ~~ ~ 3 ~~ PLAN NO.G ~I3~D~~IR DESIGNER USE/NATURE OF WORK BUILDING CONTRACTOR U rye Size 3°X3 ~ Sq. Ft.~~ 7 Z' # Rooms - ~~ # Stories Z Height Foundation Class of Const. ~ Occupancy Permit HEATING CONTRACTOR Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR - BT _ WH _ Disp _ WSoft -Lav -Sh -DW -DF - WC - FDr SP - Ur -Sink _ LTub _ Eject SS Other - CBasin -San. Sewer_ -Storm Sewer -Water FEES: Valuatio SOO O.O c~ Permit Fee Paid $ ~ Z S'~~ Park Dedication $ .~'a o . O O ISSUED BY Date S / ~'^~ Final/O. P. ~ -Qi In the performance of this work I agree to pertorm all work pursuant to rules governing the described construction. DATE 3.s =~a~,~s-_ TELEPHONE # Revised: 8/89 ZONING/LAND USE COMPLIANCE CHECKLIST JOB LOCATION : //~/ ~ //~3 (~. ®~' '`~~~~~ON I IJI PROPERTY OWNER/CONTRACTOR: ,~~.,~~~~ _ CONSTRUCTION DATA: EWLCONSTRUCTICN ADDITION ALTERATION PARKING LOT TYPE OF PROP SED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.) Cam` z z COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT DEFICIENCY/COMMENTS Use • Lot Width Lot Area Floodplain Front Yard Side Street (firont 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 : ~ Gt) GuKiy`- ~~ ~ The Director of Communit Develo ment o~r desi nee must a rov a Y P ~ g pp a 11 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. `'~~APPROVED DENIED Plan Commission Action Required Variance(s) Required REVIEWED BY Check List to Obtain Building Permit. 1.. -Get Grade Stake a. Take legal description, plot map to building inspector. 6e~--s-1-' b. a r. 2. You need these items to obtain a building hermit. a. Owner name ~ ~ ~~'"~' b. Owner:: mai 1 ing address t !t 3 ~/~-~~ c. Owner telephone number a 3 s--moo 3 S' d. Contractors name & Address !/ ~~ _ ~ ~~ 3 ,~~,~e-a.a-o-~ e. Where you're going to build `~'" f. Two Plot Plans -- g. Two complete sets of plans -`~` h. Energy worksheet on ntire house i . Know type of heat ~ow ~e-~-~ a-~+' j. Estimated cost ~o, o-v'° - '`~So"iO k. Type of shingles, siding, foundation 1. Type of construction - stick or manufactured m. Electrical AMPS ~-tu-'v n. -Who i s Mason ~~ Carpenter ~a i~~ Plumbing W Heating ~,~,-~-r E l ectr i c a l ~,~--~~-~--- o. Know zoning of property ~- 3 p. Take a check We have a blanket permit for height from airport. Departmen of Industry, LaborBHumanRelations Division of Safety 8 Buildings WISCONSIN UNIFORM BUILDING PERMIT APPLICATION NO. ~~~~ 0 Mad son, wl s37o7 Wisconsin Statutes 101.63, 101.73 APPLICATION See /ng/iuct/ons on back o/ /nk Co PARCEL NO. PERM' RE#'l~ESTI"D - CONSTRUCTION ^HVAC ^ ELEC ^ PLUMBING ^ OTHER: Owner's Name Mailing Address Telephone l/~3 © z3 S-~D 3 .S~ Contractor's Name Mailing Address Telephone ~RO~~~~ ~:OCi~N ` Lot Area Sq• ft• %a, '/., SECTION. , T N, R E or W Building Address ~/-//~3 /3.~~n ~ Subdivis' n Nam ~~ Lot No. / Block No. Zoning District(s) ~ _._ ............._' Zoning Permit No. Setb8iCk8 Front ~ S/ ft. Rear ~ ZS ft. Le ~~ ~ ft. Righ ~~ P ft. ~. l>~I~ '' ' ,.. 9 8 ~L~.~ ! 9 ' #I#`~C ~MPM~1~' i ~. `:>»N ERCaY SO UA CIE ®New ^ Repair Alteration ^ Raze ^ Single Family Two family Entrance Panel Size: ~ O amp [~ Forced Air Furnace ^ Radiant Baseboard or Panel Fuel Nat. Gas L.P. Oil Elec. Solid lar ^ Addition ^ Move ~ Garage Service: ^ Heat Pump Space Htg. ^ ^ ^ ^ ^ ^ Other Underground ^ ^ Boiler ~ Water Htg. ^ ^ ^ ^ ^ Overhead . Central Air Conditioning ^ Other " ' <!!~';'~~ [~`!F~!t13~"I€!?Q!~< ^ Other wellin unit will have 3 kilowatt or 9 o ' • SlteCOnstruCted ~ Concrete '~ '' ~+ ~~I~~~ nfiltration aontrol optionase^Fu II sealing ~. !~ ~'~~. `'. < ~ Manufactured ^ Masonry , Sewer of joints. ^ Blower door test. ^ Exterior ^ Treated Wood ~. Municipal air infiltration barrier. Unfinished Basement Q Sq. ft. '~: S'IIF"'"> ^ Other ^ Septic 1~, ':ik~' ~:0~5 ~alculateii) x ~ 7.i ^ 1-Story ~' ~ Permit No. Envelope BTU/HR o Living Area Sq. ft. ®2-Story ^ Seasonal 1~' ~`~l'1'~ Infiltration BTU/HR Garage Sq ft ^ Other Permanent Other ~ Municipal Utility ~!~, >I~T I~DI~ CAST ^ Plus basement ^ private on-site Well $ Q Q~Q,.Q p 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 Municipa ' ;and certifies that all t bove i ormation is accurate. SIGNATURE OF APPLICANT D ,~ ~~/~~~ CONDITIONS OF APPROVAL This per I I ed pursuant to the following conditions. Failure to comply ay r ult in suspension or revocation of this permit or other penalty. ~~ ~ .1 '~ E I~sU~I~ ? .~UI;ISDlCTION ^TOWN ^ VILLAGE CITY ^ COUNTY ^ STATE IND P D N OF: Municipality Number of Inspection Authority / ~- ~' ~ LL Municipality Number of Dwelling Location, if different --'--- ~S P~~A~ . S} ll~ 1i1tIS: i/f~~t'![~M'll~i'/~1T SISAL>NQ. pEEi~1f1T I'3SUI~7 8Y: Plan Review $ • 00 Inspection $ ~ Construction ^HVAC ~ NAME ~ , Wis. Permit Seal. $ •00 ^ Electrical ^ Plumbing 9 7 ~ ~ DATE S ~ c1 Other $ TOTAL $ O • f,0 ^ Other CERT. NO. ~ ~~~ ~ovoocstn.aiaul wMllE-ISSUingJUristliction YELLOW-DILHR GREEN-Inspector PINK-Owner/Agent ~boo,pp LATE S~~/ ~~ NAME_,~ ~ /~~,C/~ ADDRESS lOT ~~ BCCCK SUED I V ._~~~,~ps~~~ c~,~Z~~~ ZGNE STREET N0. /~~~ _ /18'~ ,~.~~~~ ~~" LOT D I `BENS I Gras SIDEWALK EXISTING YES ~ Np BU I !DING GRADE ELEVATIONS STAKES SET AT SITE `j' l~ , 19 q ~ i3Y ~--~~" FEE:~.OO l S'-o TdaBD CE°ART^^E`aT CF PUBL i C '~V02K5 t, the undersigned, owner or agent of the abcve described property agree to have t~,~" grade estaaiished before excavation has commenced. 4-0~' ~~2 ~'~ ~I City of Oshkosh 1/1/Q5 PARKLAND DEDICATION FEE COLLECTION RECORD Address //,fir/~/~ // ~3/ ~~- Owner"s Name .U ~ ~ • ~C ~ /.r~i~ Name of Subdivision ~~ ~~c-~~ ~~ Lot # / ~ Bldg. Permit # 2 ~ Z ~ O No. of Units Z Fee Required ~0 ~ c~ c7 Fee Paid 20© ~ o 0 Owner's signature. Inspector's signature Parks Subdivision Improvement Accts. Rec.: 362-041 SATE .3=i~--,~~ NAME CSC-U-c-v ~~ ~-~~,r- LOT /y ~- ADDRESS (' (('3 ~c-,~~0,y BLOCK '~AAD ZONE STREET N0. ~ I ~j / ~ ~C3 ~`o~o~~., C~- LOT DIMENSIONS SIDEWALK EXISTING YES ~ NO BUILDING GRADE ELEVATIONS STAKES SET AT SITE J ~-~ ,19 ~~ ? BY `",N. FEE : ~ 15~. 0~0 l~ i~^ DEPARTMENT OF PUBLIC WORKS //~ I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced. ~~ ~.~ ~.*f