HomeMy WebLinkAbout0028383-Building R CITY OF OSHKOSH
N9 28383
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 2 q G(/ PLAN NO.,4 /6 3 0 s c Z /2
OWNER ,,e 71- l ifAC /_�����-B
DESIGNER
USE /NATURE OF WORK /.,eGi.1 ,I e. At.(
BUILDING CONTRACTOR/eu-a ei9
Size *97 Sq. Ft. /0 Rooms (r 3 6 Stories Height 2 Z-
//7_
Foundation C Class of Const. 1 Occupancy Permit
HEATING CONTRACTOR if3./! -2Gf
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR fi�a%�lIG�G�
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR fI�C�/Z7z -t
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 ,P •11 #0 0 Permit Fee Paid /0 S LD Park Dedicat 0"0.0 0
ISSUED BY J .4.. Date 5 4/ -2- Final /O.P. e 1
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
7‘ G-� ____pi
s7 q,
AGENT /OWNER DATE
ADDRESS
TELEPHONE
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: Z- y S c7 Z-- ZONING:
PROPERTY OWNER /CONTRACTOR /Z4 /t
CONSTRUCTION DATA: -■EW CONSTRUCM ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
COMPLIANCE CHECKLIST (Check only those applicable)
COMPL S 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
REVI AUTHORITY: y Gt)
The rector of Community Development, or design 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.
/A DENIED
Plan Commission Action Required
Variance(s) Requir -d
REVIEWED BY: Zi� DATE: S
/6 6--c a. ce.-
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM p
Labor Human Relations BUILDING PERMIT APPLICATION NO. t7 d d 3
Division of Safety Buildings
Box Madison, Mad n, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back ofpink copy) PARCEL NO.
PERM REQUEST D J CONSTRUCTION HVAC ELEC E PLUMBING Li OTHER:
Own is Name Mailing Address Telephone
ontractor's Name Mailing Address Telephone
Lot Area
PROJECT OC* N
S .ft.
Mt, SECTION Sq. SEC O T N, R E (or)W
Building Addre Subdivision Name Lot No. Block No.
Zoning District(s) Zonin ermit No. Front Rear Left Right
7 Setbacks 3 0 ft. 1 7 ft. ft. Q ft.
PR X':: 3:: :6 ELECTR AL::::::::::9 t tAC: tP 12. :ENERGY SOURCE
New Repair Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
Alteration Raze D Two family Size: O amp U Radiant Baseboard or Panel as
Addition Move Garage Service: Heat Pump Space Htg.
0 Other Underground Boiler Water Htg
Overhead Central Air Conditioning
Other then Dwelling unit will have 3 kilowatt or
more installed ele ctric space heating equip.
R Site constructed
i Concrete PLU M f Infiltration control option is: E] Full sealing
Manufactured Masonry Sewer of joints. 0 Blower door test. 0 Exterior
Treated Wood rfMunicipal air infiltration barrier.
0 Se
Other
Septic
Unfinished Basement q. ft. P 7:`:
Permit No e �r sO2 7 BTU /HR
Living Area D Sq. ft.
1-Story Envelope
a
2-Story 8'
S ea sonal '�'�:�AT�
rY Infiltration 7 4 1_ BTU /HR
Garage �Q 2 Sq. ft. O her Permanent `Municipal Utility EST BLHL �i COST'
Other Private on -site Well
Plus basement C 1 0 Q O c7
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 implie•-..,,.i.. unicipality; and certifies that all the above information is accurate.
SIGNATURE OF APPLICANT DATE 7 -7a
CONDITIONS OF APPROVAL This permit ist issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or othe p e na lty
u Til.u,.1�- pet- ate G..endP �C' t-
NK ..___:►a_ 4 /1 it /i d i
Ai. 6; e /.A cr y- _i p-f
Municipality ❑TOWN VILLAGE a Number of Municipality Number f
G CITY 0 P tY p y o Dwelling
STATE IN EPEND T Inspection Authority Location, if different
:J USD N?
I OF: 2_.. (c
PERMflT S) (W S U 4 E RM PERMIT PE
Plan Review 449 Construction ��oif.(�
HVAC NAME i
Inspection El Electrical 3
Wis. Permit Seal 3 d .(9 o Plumbing r 9 DATE S/� Zl
Other Other
TOTAL 7 o vo CERT. NO. 4 4N S
sap 5823(R.8/90) 3o(/ WHITE Issuing Jurisdiction YELLOW -DILHR GREEN Inspector PINK Owner /Agent
DATE 51S75
NAME 64o6IL ADDRESS
LOT yZ BLOCK WARD
SUED I V 46 6 f 7A0,,.-Q- ZONE
STREET NO./02 LOT DIMENSIONS
SIDEWALK EXISTING YES 0 NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE G ,I9
FEE:170:VQ
5 :od
6
DEPART4ENT OF PUBLIC WORK:
I, the undersigned, owner or agent of the above described property agree to have the
grade estabiished before excavation has commenced.
9 534
45/
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address 2 L/ 7/ 64-11a1
Owner's Name AG(, 7 1 h 6
Name of Subdivision teeefil "-it-
Lot Bldg. Permit
No. of Units
Fee Required D 0
Fee Paid /0 0•c9
Owner' s signature L Date 5- 4
Inspector's signature 1 iJ6r -rte Date 6/61f
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
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