HomeMy WebLinkAbout0027295-Building 7 t
CITY OF OSHKOSH N9 27295
PERMIT APPLICATION AND RECORD
TYPE: BLDG Ar HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS /2-- 740 2d4e4fid.of PLAN NO9 31S 2 FZi&
OWNER
ieGe.'
DESIGNER
USE /NATURE OF WORK V „I/ G a4_,
BUILDING CONTRACTOR e-G 4 c#c t 9,z
7
Size 1. Sq. Ft. `8"O Rooms l Stories Height
Foundation i-" or
Class of Const. a Occupancy Permit
HEATING CONTRACTOR 41.z.Z4..t-a.../
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR ,---1.72 --1
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR Poti,;(
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 0 Permit Fee Paid /0 S 00 r/ Park Dedication MD 00
ISSUED BY /./a6 Date n9A Z— Final /O.P. J, V f
In the performance of work I agree to perform all work pursuant to rules governing the described construction. p%
SIGNATURE 7 this
'V�, i/ 92--
AGENT/OWNER DATE
ADDRESS
TELEPHONE
Revised: 8/89
ZONING /LANG USE COMPLIANCE CHECKLIST
JOB LOCATION: i St3 ZONING: I`''
PROPERTY OWNER /CONTRACTOR: 44
CONSTRUCTION DATA: AEW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
/ie a. -e X z z 5 7;
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (front 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 designee, 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/ACPPROVED DENIED
Plan Commission Action Required
Variance(s) Requir
A.
REVIEWED BY: i /f DATE: 2 0
2-3 Se o 2 n
State of Wisconsin
Department of industry, WISCONSIN UNIFORM
Labor Human Relations BUILDING PERMIT O 7
B APPLICATION NO.
Division of Safety Buildings
Box Madison, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
PERMIT REOUE"O
CONSTRUCTION 111 HVAC ELEC PLUMBING OTHER:
Owner's Name Mailing Address Telephone
Contra tor's Name Mailing Address Telephone
ti dim
760 luiDa-t A �e-ii/ l,01 0"3( -6313
Lot Area
P R ECT L S ft. SECTION T N R E (or
)W
/4, SEC O W
Building Address Name Lot No. Block No.
VA Jeri' ld C f 4
Zoning District(s) Zon' g Permit No. Front Rear Left Right
o /0
Setbacks n. n. 1 n. n.
t a? O 3 Occ patio I ELE TRICA RVAC`E IPMENT. 1.2 ENERGY SOURCE
l ew Repair Single Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar N.
A lteration Raze Two family Size: /0 0 amp Radiant Baseboard or Panel Gas
Addition Move Garage Service: Heat Pump Sce H
Other �IJ nderground Boiler Water Htg. 000
(U Overhead Central Air Conditioning
Other Dwelling unit will have 3 kilowatt or
Other :4. :.7::.:FOU 1O more installed electric space heating equip.
Site constructed
iTConcrete 1.0j PLUMBING Infiltration control option is Full sealing
2; »ANNA 'DIED:: Manufactured M Mason ry of joints. ID Blower door test. Exterior
rr Treated Wood unicipal air infiltration barrier.
Other ptic
Unfinished Basement -3*-.-- .�5::::
Sq. n ::5't'1IEG.:;::<::: i'.$a' ITT LOSS Caieif lated)
Permit No.
Living Area O Sq. ft.
1- S Envelope �Y �f r B TU /HR
9'
2-Story Seasonal z Infiltration P93, BTU /HR
Ot er 'ilk Permanent
Garage Sq• ft. a Other Municipal Utility I«ST BUIL GOS
Private on -site Well
Plus basement 5/ 000, 0 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 implied e Department or Municipality; and certifies that all the above information is ac urate.
SIGNATURE OF APPLICANT DATE O 4-
CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
-114 A revocation of this permi or other penalty.
/2
J��. rr W ����I-i//�/.. GP M Sri 0,.._. -it....
a
ice/ ..r_t ar .AUK/ ,e/1'L- i /.1
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leXe-,2-670-,,,- m f ea-tit .tea
Municipality Number umber o Municipality Number of Dwelling
❑VILLAGE CITY 0 P tY p y b e
STATE IN EPENDE Inspection Authority Location, if different
JUR D N'
RM W S.0 ORM PERMn
NAME /31 r iC
Plan Review O 0 I' Construction
HVAC
Inspection Electrical Wis. Permit Seal. 3a 0 Plumbing i 06, DATE 21/0 /9
Other Other
TOTAL $70. 0 J CERT. NO.
SBD5821. WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
DATE
NAME if ADDRESS
LOT BLOCK WARD
SUBOIV 1/j Lr_ 7 f,,42 ZONE
STREET NO. 3 (12./u14(.1/.17 LOT DIMENSIONS
SIDEWALK EXISTING YES 0 NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 2J ,I9 7Z— BY Y-0
FEE: ft-0-40
15; Eli
DEPARTMENT OF PUBLIC WORKS
1, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
40
(YT:'!-4C-SO
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address ‘,(0 G,r/
Owner's Name
Name of Subdivision
Lot 443 Bldg. Permit 0/72-9-5
No. of Units
Fee Required 00 .0
Fee Paid /00 .od
Owner's signature t�-- Date Q
Inspector's signature Date a- /0/9?i
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
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