HomeMy WebLinkAbout0029074-Building 4
CITY OF OSHKOSH N° 29074
PERMIT APPLICATION AND RECORD
TYPE: BLDG X HTG ELEC PLBG SIGN ZONING /e FLOOD PLAIN HEIGHT
ADDRESS 5 z•d A .E (.d PLAN NO. ZSK06o9 Z11
OWNER C1
DESIGNER
USE /NATURE OF WORK )Z'.(.c) 7 ,17fe r alfff: /"v
BUILDING CONTRACTOR c9GC7,2L--(
Size c=. Sq. Ft. //S l (p L3 Z 2
q. Stories Height
Foundation l r Class of Const. CI Occupancy Permit
HEATING CONTRACTOR /d/Ltlt.1 -6
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR 4--
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR Al„Iii ,/A
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)000. O P Permit Fee Paid /0"F° 0 Park Dedication /O 0 6'e
ISSUED BY ,1 -4 446 4 Date 4 Z- Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE G-. 1
AGENT /OWNER ATE
ADDRESS
TELEPHONE
Revised: 8/89
ZONING /LANG USE COMPLIANCE CHECKLIST
JOB LOCATION: /2_5 .c f 7x),41 l.,(,) ZONING: t(
PROPERTY OWNER/CONTRACTOR:
CONSTRUCTION DATA: ✓NEW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
ye d' "/e/-,-'(. 2zKz z., taSZ
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frart 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:' U 'C
The 0 rector of Community Development, or signee, must approve all plans, except the
folio ing: (1) Alterations or interior work when the use is conforming and when no change
in u5- 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 withouttr eferral to the Director of Community Development, or designee.
VED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY I 9 DATE: 4/17PZ-
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State of Department of Industry, WISCONSIN UNIFORM
Labor Human Relations BUILDING PERMIT APPLICATION NO. /D 7 �G
Division of Safety 8 Buildings
Box Madison, Mad n, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See /nShucUons on back of pink copy) PARCEL NO.
PER
1 J REQ S
CONSTRUCTION UC ON HVAC ELEC 1=1 PLUMBING El OTHER:
Owner's Name Mailing Address Telephone
Contra is Name Mailing Address Telephone
2 7100 4,9 w Lot Area
Sq. ft. /a, /s, SECTION T N, R E (or)W
Building Address S Name Lo t No. Block No.
/2.5-3 a... 0
Zoning District(s) Z ing Permit No. Front Rea Left Right
Setbacks 2.-.Y.- ft ft. 0 ft. 2-0 ft.
,IEj� :...�...F�.E�"'IR #�f' AC; IPIiEE M T:: 1 >:<ENERQ'�::
lew Repair Single Family Entrancg _Pape) N Forced Air Furnace Fuel Nat. L.P. Oil Elec. Solid Solar
'❑Alteration Raze Two family Size: am. Radiant Baseboard or Panel Gas
❑Addition Move Garage ervice: Heat Pump Space Htg.
Other U nderground Boiler Water Htg, c
Overhead Central Air Conditioning
D Dwe ling unit l have 3 kilowatt
❑Other iA0copmyype ini:iip.owomloor Other
more installed electric space heating equip
Concrete a Infiltration control option is:
ite constructed p Full sealing
Masonry of joints. Blower door test. Exterior
l?: anufactured gwer
Treated Wood Municipal air infiltration barrier.
Other Septic 1:II T::L
S Calc l to
Unfinished Basement 67 v Sq. ft. STOR ESE:
Permit No.
/�V 1 IMIM: y
Living Area Sq. ft. ry AT Envelope l p BTU /HR
2-Sto Seasonal 11. gii
Z
Infiltration 7�- BTU /HR
g q. 0 Other ,Permanent
Garage S ft. Municipal Utility i
Other
Private on -site Well
PI basement 4 NO
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 Depart t or Municipality; and certifies that all the above information is ac urate.
SIGNATURE OF APPLICANT e.--. DATE DATE i( l
CO DITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this per it or other penalty.
Paz ex I-- r et- .Ce-4 .1,� -za,e-e-
Gam.( -1,a
TOWN
VILLAGE CITY ❑COUNTY Municipality P tY Number of Municipality tY Number of Dwelling
STATE I END Inspection Authority Location, if different
R
IF7!RAi{.i�lFllall�tr_..
Plan Review 7�Q' 0a Construction
HVAC
Inspection ID Electrical f NAME c
Wis. Permit Seal. 30.00 El Plumbing I d DATE /a n Z
Other 0 Other -.S o
TOTAL CERT. NO.
SBD 5823 (R. 8/90)3 WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
CATE 6/0 Z--
NAME /C f ADDRESS
LOT 2-(a BLOCK WARD
SUBOIV.� ZONE
STREET NO. /2_3/4.X /1 LOT DIMENSIONS
SIDEWALK EXISTING YES 0 NO JE
BUILDING GRADE ELEVATIONS STAKES SET AT SITE G -'`f ,19 9 Z BY ,L
FEE: 13 :OO
$1560
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
00,4538
,4S Sd
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /2.53 L6 irc1 2/
Owner's Name 6-7-E4
Name of Subdivision
Lot 34 o Bldg. Permit 9 07Y
No. of Units
Fee Required /64.
Fee Paid /OD.d
Owner's signature 4
/0 /Af Date E7/7k;
Inspector's signature iaVA(10/./AnrW D ate 6/9/7*Z
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
(AVER ADD /Z. 4
DATE JUN 8 199 PERMIT USE /1/3
Woxk consists of
GENERAL CONTRACTOR
MASON CONTRACTOR ZONE
Width of lot DATE INSPECTIONS
n REMARKS
V V;°
w A
.c
y
m
No-
Front of lot MAILING ADDRESS