HomeMy WebLinkAbout0029075-Building t CITY OF OSHKOSH N°_ 29075
PERMIT APPLICATION AND RECORD
TYPE: BLDG,' HTG ELEC PLBG SIGN ZONING �1 FLOOD PLAIN HEIGHT
ADDRESS
.L f zoo/R) PLAN NO. Zg� 0 Co 92
OWNER A
DESIGNER
USE /NATURE OF WORK )7e4 i 1 5 /44
BUILDING CONTRACTOR QG "1W
p l
Size Sq. Ft. S Rooms ''3, tI Stories Height ,v
Foundation C•-!r Class of Const. IP Occupancy Permit
HEATING CONTRACTOR 61.4(.rAJ
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR .1,1 yI
Electric Serv. New Change Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR l.{J�l iY!/ f (C/1
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuati .3TO 0 t) Permit Fee Paid �'O Park Dedication$$ /DD oD
ISSUED BY Date Final /O.P. CV 7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE L-- 0,At
AGENT /OWNER DATE
ADDRESS
TELEPHONE
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
7 ZONING:
JOB LOCATION: Z (Q eF fo? ./L yul21: G�
TRACTOR --e%- d 4 �t,��
PROPERTY OWNER /CON C
CONSTRUCTION DATA: ,,AEW CONSTRUCT»1 ADDITION ALTERATION PARKING LOT
TYPE OF PROPO ED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
03 zs 5 A t'
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: v 4/-
The Director of Community Development, or d ignee must approve all plans, except t he
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.
LPPROVED DENIED
Plan Commission Action Required
Variances) Required
REVIEWED BY: j L_
D ATE: (0 7
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM p -7
Labor a Human Relations BUILDING PERMIT APPLICATION NO. 2 /D S
Division of Safety 8 Buildings
Box Madison, Mad n, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
EOUE TE CONSTRUC HVAC 111 III III
Owner's Name s Mailing Address Telephone
Cont r Name Mailing Address Telephone
Z7 t�
Lot Area
sq. ft. TI
a SECTION T N R E or W O
Building Address Subdivision Name Lot No. Block No.
2. A_ _as� a_ 1fii -L.ia e..-- 2 P
Zoning Distr oning Permit No. Font Rear l� s
Left r 7
Right
J Setbacks Z ft. r ft. 7 .s ft. J ft.
I:: :1 :ii ::O cupancy 9 ::ELECTRICAL: :9.:::HIVI.IC::E tPM....:::::;::;:::::::::;::::1:2 ENE RGY:SOURCE
New Repair ar
Single Family Entrancefel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
Iteration Raze Two family Size: /O Z amp Radiant Baseboard or Panel Gas
❑Addition El Move Garage ervice: Heat Pump ce t9. El
Other Underground Boiler Water Htg. El El
Overhead Central Air Conditioning
A. 'r YID: .::t.',:::...:,:....
UND TJON
Dwelling unit will have kilowatt
Other Other more installed electric space heating equip
Concrete :10. P. ;UMBIPI Infiltration control option is 0 Full sealing
Site const ructed
LLIIII
Masonry
of joints. Blower door test. Exterior
ry
I
Manufa r S er
°lIREl�? €INVOLVE
ctu ed
Treated Wood Munici air infiltration barrier.
0
Septic
2 1:5 =:::IIE: Galculaiia
Unfinished Basemen/' S Sq. ft. :.�'rs.r:�`IE$s Permit No I,
1-Story >w Envelope 1 d 07 7. 3 BTU /HR
g Sq.ft.
Living Area 26 Z!P 1. 0 2 Sto Seasonal
57 ry Infiltration BTU /HR
Garage 5 7 S Other Permanent LJ j' Municipal Utili
q Other LJ
Private n Well
Pius basement
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 on the Department or Municipality; and certifies that all the above information i acc te.
SIGNATURE OF APPLICANT L-- DATE
CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalty.
e le,4 7.-)-- a /faZcf--)17). "i to s L _I, 0 /L_ i.La_ as t
i /.a tit a,_._ ...<;a
Municipality Number of Municipality Number of Dwelling
CI TOWN ❑VILLAGE CITY ❑COUNTY P Y P tY e 9
p STATE IND PEND N Inspection Authority Location, if different
JURISDICTION L
Plan Review
•B o ,Construction At Inspection HVAC NAME At
Electrical
Wis. Permit Seal .O 0 Plumbing DATE Z
Other Other
TOTAL 7o O 0 d� CERT. NO. �D
SBD5823(R.8/90). `ter WHITE Issuing Jurisdiction YELLOW- DILHR GREEN Inspector PINK Owner /Agent
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CATE 67(e19
NAME ,1 ADDRESS
LOT 3 BLOCK WARD
SUBD1 V. .1.,�,�,yv ZONE
STREET NO.
W Av LOT DIMENSIONS
SIDEWALK EXISTING YES NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE cj ,19 Cr..- BY kAi
FEE: Q -±9:00.
I /5;0o
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'S.559
v
4S tI S
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /7,-(6.
Owner's Name ri
Name of Subdi vi si
Lot 3 `f Bldg. Permit 2-1O7'
No. of Units
Fee Required /6o, o V
Fee Paid /Oo•OD
Owner's signature 7F/:::1/42 Date 6
Inspector's signature kt n Date (v 9 v
Parks Subdivision
Improvement
Accts. Rec.: 362 -041