HomeMy WebLinkAbout0029929-Building CITY OF OSHKOSH N9 29929
PERMIT APPLICATION AND RECORD
TYPE: BLDG, HTG ELEC PLBG SIGN ZONING e_ FLOOD PLAIN HEIGHT
ADDRESS Z 55 h2 .r/ PLAN NO.R7 I /S �L-
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OWNER
DESIGNER Q
USE /NATURE OF WORK /.l a'
BUILDING CONTRACTOR OliC/ A- J/ 14 61 111
Size -94. Sq. Ft. //o3 Rooms 6 —3 Stories Height
J //1
Foundation L Class of Const. k Occupancy Permit
HEATING CONTRACTOR r
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR 6-c G°!'tr
Electric Serv. New Change El Temp El Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR f/. 1'
BT WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation 05-000.0V Permit Fee Paid 7r 5 C Park Dedication /0 0 00
ISSUED BY A i7 7 Date 7 36 Z- Final /O.P. /02-029 9 2
In the performance of this work I a to perform all work pursuant to rules governing the described construction.
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SIGNATURE �r 7 3 7 p�
AGENT /OWNER ATE
ADDRESS
TELEPHONE
Revised: 8/E19
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: Z S 7121 a.9 ZONING:
PROPERTY OWNER /CONTRACTOR: CA- 1
CONSTRUCTION DATA: Nl-_ci CONSTRUCTI{N ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
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COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frcrtt 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
ight
REVIEW AUTHORITY: J(j'-" ,,A�1�v
The Director of Communit Develo ment, or �esi ee ust a rove all lans exce t the
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following: (1) Alterations or interior work w en 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.
[/APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: J' DATE:
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State of Wisconsin
Department of Industry, WISCONSIN UNIFORM <P9 9.2 9
Labor Human Relations BUILDING PERMIT APPLICATION NO.
Division of Safety Buildings
Box 79
Madison, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
R E 1 R VESTED
CONSTRUCTION HVAC ELEC PLUMBING OTHER:
Owner's Name Mailing Address Telephone
Contractor's Name Mailing Address Telephone
671.ar(GLG"Gd�c 2 7 o tdt Wt. 4, 0-/eleed-,-'2 1 -632
y r ;:i Lot Area
PROJE
S ft. /s, SECTION T N, R E (or)W
Building Address Subdivision Name Lot No. Block No.
Zoning District(s) Z Permit No. Front Rear Left �i Right
Setbacks `T ft. ft. a ft. 061 ft.
:::.ii:::: :::i::Y::::i:i:;:::i::: :.:3; III:::: ELECT "::::is:::iFii::F:IVAC::: QU IPM: EN1:::::: i:: ::i::::::::IL:::::ENERGY::SOURC ::::E:::::<:::::
ew 0 Repair Single Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
Iteration Raze Two family Size: /00 amp Radiant Baseboard or Panel Gas
8
❑Addition Move Garage ice: Heat Pump SPace m9•
Other Underground Boiler Water Htg.
Overhead Central Air Conditioning
Other Dwell ng unit will have 3 kilowatt or
Other 4? z '1 FO NDA O more installed electric space heating equip.
Site constructed
)St Concrete U MBWI. Infiltration control option is 0 Full sealing
`s f R E1 Manufactured asonry Sewer of joints. 0 Blower door test. 0 Exterior
Treated Wood Municipal air infiltration barrier.
El Other
Septic
Unfinished Baseme Sq. ft.
P N
i 1 -Story i »3 Envelope 2 2 0. 2- 1 1 BTU /HR
Living Area 1 03 Sq. ft.
-sto
3,0
`1��iC!'A�`IEE� /32 G, BTU /HR
1 ,2-Story 0 Seasonal Infiltration
s 4 oO er Permanent
Garage Sq. ft. Municipal Utility 14 S ST
Other
Private on -site Well
Plus basement 'f 0 0 0 .0 D
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 impl r -1.. artmen nicipality; and certifies that all the above information is accurate.
SIGNATURE OF APPLICANT t it DATE 7
CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to com ly may result in suspension or
revocation of this permit or other penalty.
22-11 0 '7 U /a 1 -10' 't 4 e y 0 t e- 6 i Ci4 14 6 (Z l 't
i -g .y /t_, A A pr defer 7 F
.52-gLet-G! a n d� u� 7` /1-1)//e ,P/..t
a} z e i(#6.
_.6.E....... 4' ��.�...1.. A
_i_,' /Y_ ce..� -ice S
1 Municipality Number f
o M nici Municipality Number ❑TOWN ❑VILLAGE CITY COUNTY u a u ber of Dwellin
OU P tY P tY 9
STATE INDEPENDENT Inspection Authority Location, if different
OF: l/ L t O
`:P tfvQ!ItAIiIPa
Plan Review `io O 'O Construction
HVAC NAME 1 1( Inspection Electrical
Wis. Permit Seal. '0. 00 Plumbing DATE 77 CI zi
Other Other S S
TOTAL 7C 0 D CERT. NO.
SBD 5823 (R. 8/90) u o 30 j 1HITE issuingJurisdiction YELLOW DILHR GREEN Inspector PINK —Owner /Agent
DATE ?/Zq' /cj 2
NAME iCtiZ G'X &Lac- ADDRESS
LOT 9 7 BLOCK
WARD ARD /3
SUBD1V. c 11,4pyvi ZONE
STREET NO. /d SY Zv G' LOT DIMENSIONS
SIDEWALK EXISTING "YES 0 NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 8f 3 ,19 9Z BYKr"
FEE: $io-Qo-
4 /10 1 47 /4
DEPARTMENT OF PUBLIC 'WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade estaaiished before excavation has commenced.
00 534
X5842
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /2 S"5 Li' I W
Owner's Name iaGdC44-
Name of Subdivision l6
Lot 2 Bldg. Permit 9 2 9
No. of Units 1
Fee Requi red /0 0.0 0
Fee Paid o e. o o
Owner's signcture Date 74//2
Inspector's signature "4644 Date
Date
Parks Subdivision
Improvement
Accts. Rec.: 362 -041