HomeMy WebLinkAbout0029928-Building a
CITY OF OSHKOSH N°- 29928
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING re` FLOOD PLAIN HEIGHT
ADDRESS I Z S1 li(/ War PLAN NO./1 /I 4 t i zr-.-
OWNER ed o-- Gc.G- Gt-r
DESIGNER S Q
USE /NATURE OF WORK /J T,e GTi6
BUILDING CONTRACTOR ,,��11
Size Sq. Ft. 9 Z Rooms 3/J� Stories /3--( Height 23
Foundation Cl'L Class of Const. (T Occupancy Permit ___5f______
HEATING CONTRACTOR 1
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR C.rz--72C !--)-l'
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR Vie11..-0
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
3o OO(? r2� O0
FEES: Valuation P ermit Fee Paid Park Dedication 100 0 0
ISSUED BY gli9 1 1 .1-y u� Date 00 `cI Z Final /O.P. J 9 3
In the performance of this work I agree to rf rm all work pursuant to rules governing the described construction.
7
SIGNATURE 7 3I 4g."-'
AGENT /OWNER TE
ADDRESS
TELEPHONE
P vised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB- LOCATION: Z� f Lddzy' ZONING:
g
PROPERTY OWNER /CONTRACTOR:
CONSTRUCTION DATA: CONSTRUCTI{N ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
COMPLIANCE CHECKLIST (Check only those applicable)
COM' IES 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: COAltr4
The Director of Community Development, or d ignee must approve all plans, except the
following: (1) Alterations or interior work when he 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 withpdt referral to the Director of Community Development, or designee.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: '1)1/ GATE: v
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM
Labor Human Relations BUILDING PERMIT APPLICATION NO. o C/ S ir
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.
PERM IT
CONSTRUCTION 111 HVAC ELEC PLUMBING OTHER:
Owners Name Mailing Address Telephone
Contractor's Name Mailing Address lephone
/C G8 a76 o /,(1,,,a\ -D -L i t
Lot Area
C:r T S ft.
/a
Sq. /s, SECTION T N, R E (or)W
Building Address Subdivisio Name Lot No. Block No.
2-57 I1 42 �s
Zoning District(s) oning Permit N ront Rear Le I Ri ht
Setbacks °2 -7 ft. ft. ft. ft.
t iiiii. .If....ELE0'I10CAt... 9... 1111A6 EQU1PMENT..: ENERGY SOURCE..
A New Repair Single Family Entrance Panel 0 Forced Air Furnace Fuel Nat. L.P. Oil Elec. Solid Solar
Alteration Raze Two family Size: /QC amp Radiant Baseboard or Panel Gas
Addition Move Garage Service: Heat Pump ce9•
Other Underground Boiler Water Htg' Zi 1=1 0 El 12 El Overhead Central Air Conditioning
Other Other Dwelling unit will have 3 kilowatt or
more installed electric space heating equip.
<10. P UM tN Infiltration control option is ❑Full sealing
Site constructed
EA?IN: fEID Manufactured Masonry S e er of joints. LJ Blower door test. LI Exterior
Treated Wood 0 Municipal air infiltration barrier.
Ot her e tic
7� .S: STi $ES: p s3 A':I!"::Lt S:(Calculatec#)
Unfinished Basement Sq. ft. Permit No
7 j 1- Story Envelope Y7 9 BTU /HR
Living Area 9 &I- ft
2-stor 3
Seasonal "1�
401{7.: ry a ..�ItA�`E#� In filtration 7( 0 BTU /HR
T Permane Municipal Utility
Garage Sq. ft. ')I r: jIL CO;;.
■Private on -site Well ii,-...-.., ❑Plus basement 7 O00 Cn c7
The applicant agrees to comply with all applicable codes, statutes and or 'nances and with the conditions of this permit; understands that the issuance of the
permit creates no legal liability, express or implied e Department ni ipality; and certifies that all the above information i accur ttte.
SIGNATURE OF APPLICANT DATE 7 3 G�
CONDITIONS OF APPROVAL This permit ist issued pursuant top the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalt
-6(rje,e a any 10 .fi eV l 4 -1 re-- it
1 elLe _e j r •�,,.,4 dA --4:-0-t o TS .�/.(./,/0.,
(t z i Y %..7 J.eK G2Rer-C.ry 7 Q
.e oCQ- /D 4/./.4..&,,t2./(2.e.., 2.i i ,;(.�Fa/a/
T Municipality OWN ❑VILLAGE a It Number of Municipality Number of Dwelling
CITY 0 P Y p
STATE p INDEPENDENT Inspection Authority Location, if different
RISDD Nl
!�p!ltlEfyil.: Milli T:<;>: >:::::::s
PEES
Plan Review 40,0 O Construction
HVAC NAME if.f.lid,f
Inspection Electrical 1 l�
Wis. Permit Seal I 0 .0 0 Plumbing I l 1 0 7 DATE 7/30/9 Z
Other Other
TOTAL 7 •0 0 CERT. NO. 6
SBD 5823 (R. 8/90) WHITE Issuing Jurisdiction YELLOW- DILHR GREEN Inspector PINK Owner /Agent
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DATE
NAME C�.�t -O
ADDRESS
SUBOIV.
ZONE
STREET NO. LOT D I MENS I CNS
SIDEWALK EXISTING r DES
El NO
8U1
LDING GRADE ELEVATIONS STAKES SET AT SITE 3 ,I9 q2
FEE: $1O.UQ By (�r�
/rad
Ldp
DEPARTMENT OF PUBLIC WORKS
1, the undersigned, owner or agent of the above described propert y agree to have the
grade estabiished before excavation has commenced.
00,1533 6
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address Z 57
Owner's Name ed,7
Lam..
Name of Subdivision
Lot
Bldg. Permit Z�
No. of Units
Fee Required H•a a
Fee Paid 0-0,o
Owner'
s signature t--
Date 7 J
Inspector's signature
Date 30 q Z-
Parks Subdivision
Improvement
Accts. Rec.: 362 -041