HomeMy WebLinkAbout0027480-Building CITY OF OSHKOSH N°_ 27480
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS i __�1 A 1.✓ PLAN NO. 3 ZO O'Zqz /Z
OWNER
DESIGNER
USE /NATURE OF WORK ,4 A i*or ‘4,1
BUILDING CONTRACTOR eNv?'L!/(
Size Sq. Ft. Rooms 6 Stories I Height
Foundation &C Class of Const. Occupancy Permit
HEATING CONTRACTOR d� �C-G( -1.
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR eee--
Electric Serv. New Change Ter p U Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR v /6
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 30) DD 0 0 Permit Fee Paid b -.C." 0 I Park Dedication M .O a
ISSUED BY 19 .{,t Date 7 1 2-7 /4 Z--- Final /O.P. 1 7%C 9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 2.7. 7241
AGENT /OWNER DATE
ADDRESS
TELEPHONE
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST r i JOB LOCATION: /23 7 l,(� ZONING:
PROPERTY OWNER /CONTRACTOR:
CONSTRUCTION DATA: CONSTRUCT D1 ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
J
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frait 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 d signee, 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 withou referral to the Director of Community Development, or designee.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Requi d
REVIEWED BY: Aff/ DATE:
3 Z a o z/2--
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM
Labor a Human Relations BUILDING PERMIT APPLICATION NO. ?7 cJ 0
Division of Safety 8 Buildings
Box 7969
Madison, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
REM R#E#TE
C ONSTRUCTION ELEC El PLUMBING El OTHER:
Telephone
❑HVAC
Owner's Name Mailing Address p
Contractor's Name Mailing Address
2 te--",<-
/�!�!:LO/'► Lot Area
i' l.�. ROMO:$�: C a
N
ft. '/s '/s SECTION T N, R E (or)W
Building Addre c Subdivi io Name Lot No. Block No.
/23 9 P 7
Zoning D trict((s) Zo g Permit No. ront Rear Left Right
Setbacks ft. ft. ft. ft.
1
PROJEC Occulpancy E. ELE T ICAL 9 H.iVAC NT' 2 1 ENERGY SOURCE
E' New Repair /C] J�'Single Family Entranc Panel .0 Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
Alteration Raze Two family Size: (O amp Radiant Baseboard or Panel Ga
Addition Move Garage Service: Heat Pump Space Ht9• El
Other xUnderground Boiler WaterHtg.
Overhead Central Air Conditioning
Other Dwelling unit will have 3 kilowatt or
Other more installed electric space heating equip.
Site constructed Concrete 10, PLUM G.. Infiltration
control option is Full sealing
AR I)�VE is Manufactured Masonry Sewer of joints. Blower door test. Exterior
Treated Wood unicipal air infiltration barrier. •Other Septic 13:;: igAti 055. C
aicutlatecf
Unfinished Basement Sq. ft.: :<$T#
Permit No. /f/. BTU /HR
Living Area S ft.
1 -Story 5 Envelope
q
S ory Seaso a Infiltration U
Other permanent
Garage Sq. ft. unicipal Utility ;'il:!:. ..C...
r .4.
Other
Private on -site Well Ono
Plus basement
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understar that the issuance of the
permit creates no legal liability, express or implied, on the De_ me S M nicipality; and certifies that all the above information is accurate. �i
SIGNATURE OF APPLICANT DATE T
CONDITIONS OF APPROVAL This permit ist issued pursuant to the following conditions. Failure to comply may result in suspension or
re of this pe or o p en a lt y.
TOWN Municipality Number of Municipality Number of Dwelling
Afe irse..4.4,--peteri#0, e
O N ❑VILLAGE ITY 0 P tY P b 9
❑STATE IND E ID Inspection Authority Location, if different
OF: ILS�l2
EDS):: IW .a11 M?ORAi11+1:RNU
S.. E>I 'tE #11�
SEilL f[�.
Plan Review O 40 ?Construction
f .e.x.zeoba.. e c.i.......i
8
HVAC
NAME
0
Inspection Electrical >0 1_ 3 3 O
Wis. Permit Seal. 30 Plumbing DATE L/7 7A 7.--
Other Other
TOTAL 70. CIF) CERT. NO. e� 5. 5r0
SBD 5823 (R. 8/90) 3 WHITE issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /Z3 id O i
Owner's Name ``__.(6/ .�r
Name of Subdivision 7.1),€40eel/? ,46(--,"
Lot /9 Bldg. Permit Z 7 47)
No. of Units
Fee Required //419.00
Fee Paid /00.00
Owner's signature 71;,_ Date 07-3Q- qJ
Inspector's signature Date 21Z7/c�1-/
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
DATE 2/2 -4 z
NAME ADDRESS
LOT /9 BLOCK WARD `3
SURD IV. AtZt t ZONE
STREET NO .�-?3/ Zv 6t).4 LOT DIMENSIONS
SIDEWALK EXISTING 'YES El NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 7 ,19 9 2 BY
FEE: $1
7/5
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade estai,iished before excavation has commenced.
0
72
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