HomeMy WebLinkAbout0027100-Building CITY OF OSHKOSH N9 27100
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS /Z 3 7 ,4 i‘tiat PLAN NO. 9' 1099 Q
OWNER 4c;Q.l I I a %676454
DESIGNER ,Q
USE /NATURE OF WORK )2 /e u/W e
BUILDING CONTRACTOR nen/A
Size j Sq. Ft. 97 Rooms 5 Z S 1t 4.- Height
Foundation l. �y drt-- Class of Const. Occupancy Permit 4
HEATING CONTRACTOR /,:J -L
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR r! e..�
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 4-7
A/Ail
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
7 10 0001
FEES: Valuation Permit Fee Paid c.0 Park Dedication /1e.ao
ISSUED BY .-4, Date /`.�J /9Z Final /O.P. -9a
In the performance of this work agree to perform all work pursuant to rules governing the described construction.
SIGNATURE k c ^3
AGENT /OWNER DATE
ADDRESS
TELEPHONE
RevisFai: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: /237 0> A ,U /I,J" ZONING: t
PROPERTY OWNER /CONTRACTOR: /a" C�c9� -t4 -f
CONSTRUCTION DATA: ,./NEW CONSTRUCTKN ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
I i Div o I
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (from 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: L
The Director of Community Development, or ddgignee, must approve all plans, except the
following: (1) Alterations or 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.
ROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: DATE: Aar 7
i p/ ?/J
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM
Labor Human Relations BUILDING PERMIT APPLICATION NO. �/00
Division of Safety Buildings
Box Madison, Mad n, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
I�I
PERMIT REQUESTED 'CONSTRUCTION 111 HVAC 111 ELEC El PLUMBING I I OTHER:
Owners Name Mailing Address Telephone
Contractor's Nam Mailing Address Telephone
�G� X74 o a -C /d (9A,
Lot Area
PROJECT .00 A TIO N Sq. ft. /a, SECTION T N. R E (or)W
Building Address Subdivision Name Lot No. Block No.
t i Z, 3 7 h� I l Zoning stricts) Zonin ermit No. Front Rear Left Righ
Setbacks `2 ft. Y9 ft. S% S ft. O ft.
3. !fin 6 .:ELE�.I�::::.> E >HVACE IPME
IVEMERGY SOURCE.
ew Repair Single Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
Alteration Raze Two family Size: ,/D 1 a mp Radiant Baseboard or Panel GE
❑Addition Move Garage S rvice: Heat Pump SP
Other Underground Boiler Water Htg.
Overhead Central Air Conditioning
D `1 7? FF
Other Dwelling unit will have 3 kilowatt or
❑Other more installed electric space heating equip.
tL constructed Concrete 10 PI.0 I OING Infiltration control option is Full sealing
Manufactured Masonry er of joints. ❑Blower door test. Exterior
Treated Wood Municipal air infiltration barrier.
Other
Unfinished Basement Z.- Sq. ft.: IE Peptic 7 EA OSS (Calculat
Permit No.
i BTU /HR
Living Area Sq. ft
1 -Story Envelope �f7 O
0
•3
2-Story 0 �A E� Infiltration /7 BTU /HR
474/19 Ot er Permanent
Garage Sq. ft. Municipal Utility 4 :EET Bt .41).i t w
Other
Private on -site Well
Plus basement 7 UV
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 De artme unici lity; and certifies that all the above information is accurate.
N
SIGNATURE OF APPLICANT LIY"► DATE Of --%-.1 7
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.
/444701.1:/ ?-i efel*.e/6
f i Dr i Iv'��
c
1 7 ,'i ,O'' ors, /i m /i'
ali Number
❑TOWN ❑VILLAGE CITY 0 COUNTY Municipality
P tY Number of Dwelling
111 STATE DE E I T Inspection Munici Auth of Location, if different
RIS ION ff
:::::pERINt. S) 1(V1S: i�liwoRM?IA'gsmip
E' tSSt S'
CAE SE1L tom:
Plan Review 1 •80 A Construction I/�J" t-
VAC YJ NAME 9 /�C'K�
Inspection ❑Electrical 3 n
Wis. Permit Seal, 3 0 c3 Plumbing DATE 1 1 9
3 Z
Other Other
TOTAL
'?O .o0 CERT.NO. 1 C)
SBD 5823 (R. 8/90) 3 Ofro WHITE Issuing Jurisdiction YELLOW —DILHR GREEN Inspector PINK Owner /Agent
DATE I /3 o /5 Z-
NAME 664/1--1"-- ADDRESS
LOT Acf BLOCK D
SUED 1 V 7,,J��-64 ZONE
STREET NO. /2 3 7 ji).`J.Ga i LOT DIMENSIONS
SIDEWALK EXISTING YES El NO Eji
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 24 ,Ig gin_ BY
FEE: $4478a
1' t 5% oo r
,O
DEPARTMENT OF PUBLIC WORKS �p,
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
4¢ 001475
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /2, 3 7 i /2(i
Owner's Name
Name of Subdivision c,� 4/4-7771-.'
Lot /12 Bldg. Permit 7 /00
No. of Units
Fee Required
Fee Paid /at-0,00
Owner's signature c ir6;;T Date 07
Inspector's signature 1„,— Date 0/
Parks Subdivision
Improvement
Accts. Rec.: 362 041
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