HomeMy WebLinkAbout0023275-Building CITY OF OSHKOSH No 23275
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING L FLOOD PLAIN HEIGHT
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ADDRESS /Z dC lid PLAN NO. ///N/®sW.
OWNER 4r.4 c 4 �.44:1.4Z- a..C. cL� .D:4-
DESIGNER
USE /NATURE OF WORK (-L4..d 1 ie-
BUILDING CONTRACTOR AeJrai
Size Sq. Ft. /D Room 4 Stories d Height 3
Foundation �.�fi t- Class of Const. Occupancy Permit
HEATING CONTRACTOR /'ciiGl
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR 4"7"1G %Z
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR War
a-
WH Disp WSoft CBasin
_Lax/ Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation 30 000. OV Permit Fee Paid 0 S7 0 m Park Dedication b O O O
ISSUED BY ,a -e► s.-- Date //:i /9 Final /O.P. i/1 '1 j
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE r„...., 6 z 6 9
AGENT /OWNER DATE
ADDRESS
TELEPHONE
4 I L O q/,e--
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM �j
Labor Human Relations BUILDING PERMIT APPLICATION NO.-
O. -23Z (5
Division of Safety 8 Buildings
Box Madison, Mad n, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
PER. R.E E E
IKCONSTRUCTION HVAC ELEC 111 PLUMBING OTHER:
Owner's N e Mailing Address Telephone
X0.71 a The 5}/9® 51. 0Aii,is/ .2 6 32-3
Contractor's Name Mailing Address Telephone
Lot Area
40TL.00A
Sq. ft. /s, /a, SECTION T N, R E (or)W
Building Address Subdivision Name Lot No. Block No.
Zoning Dis Zoning Per it No. Front .0- RearJJ Left Right
I Setbacks o2 ft. Y P ft. i� ft. /u ft.
1.. PR�C' t:>:: .::':6.::ELEC'h.RI A HVAC ICIUIPMEN 1.2.:ENERGY SOURCE
N New Repair Single Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
Alteration Raze Two family Size: amp M Radiant Baseboard or Panel Gas
Addition Move Garage MIrvice: Heat Pump Space Htg. g
Other Underground Boiler Water Htg.
Overhead Central Air Conditioning
Other Dwelling unit will have 3 kilowatt or
Other 4 1 FO DA O more installed electric space heating equip.
��pI Site constructed Infiltration control option is: sealing
Concrete 1 R��$ �11 :«::<<:«<:z<::: >i P 0 sealin
2 door test Exterior
�;[<;;[��(E�;< ;:<z<; ❑Manufactured Masonry Sewer of joints. Blower d
7 �[Q' Treated Wood AC Municipal air infiltration barrier.
7/ ❑Other
Unfinished Basement Sq. ft. <h. Septic 1:3« IAT:L�S (OSfCktls'i(te�#)
Permit No. -2-7-1-173
W 1-Story Envelope BTU /HR
Ching Area �7� Sq. ft. ry 1
5.-- 2-Story Seasonal
Infiltration 7--/97 BTU /HR
Garage S ft. er Permanent Municipal Utility 14 ESTt LOIN COS'
Other Private on -site Well
Plus basement wt,
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 Rib D ATE
S�ZC f/
CONDITIO S 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.
jjr or
T Municipality Number of Municipality Number of Dwelling
OWN ❑VI LLAGE C ITY 0 P tY P tY
r:� 7 STAT EPEND Inspection Authority Location, if different
€SRI DDIC TION 7/
S: P U t ORM PERun PE ISSUED BY
u
Plan Review d. d'� Construction �t:�G�`
HVAC 9 75�� N AME frkie Inspection Electrical Q
Wis. Permit Seal 3° `o 0 Plumbing DATE l 3 /7
Other Other
TOTAL 70. 0 o CERT. NO. J d
SBD5823(R. 3 1:7. WHITE Issuing Jurisdiction YELLOW —DILHR GREEN Inspector PINK Owner /Agent
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: ZOO G ;41 7 ZONING:
PROPERTY OWNER /CONTRACTOR: Aclak14
CONSTRUCTION DATA: L/ NEW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PRO CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frart 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 Di ector of Community Development, or esignee, 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.
C/ APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: L_g#
DATE: f`
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DATE
6
ADDRESS
LOT `7 BLOCK WARD
SUBDIV. C J�
ZONE
STREET NO. /'if /.f /�lj,� 4 LOT DIMENSIONS
SIDEWALK EXISTING "YES 0 NO [3]
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 51/3 ,199/ BY ll
FEE:$
(s ov
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.
a
004328
328
4 -3t 4,s
City of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLLEECTION RECORD
Address /Z0/ ,j/
Owner's Name /er.4 2 ,4
Name of Subdivision leiz
Lot 7 Bldg. Permit
No. of Units
Fee Requi red MO. O
Fee Paid /OO.OD
Owner's signature l=-�l�1 Date S -2o Q it
i
Inspector's signature Ae A_„ Date 5
Parks Subdivision
Improvement
Accts. Rec.: 362 -041