HomeMy WebLinkAbout0030014-Building L
CITY OF OSHKOSH N2 30014
PERMIT APPLICATION AND RECORD
TYPE: BLDG Ar HTG ELEC PLBG SIGN ZONING 1 FLOOD PLAIN HEIGHT
ADDRESS a-7 S .(f p
P LAN NO. I I9 00 1 I�
OWNER 672.4 Z (Le A-4 4
DESIGNER
USE /NATURE OF WORK d*e iZta /J Q C(,`
BUILDING CONTRACTOR 4G'U7vei
Size Sq. Ft. 0 V Rooms [0 -3/31.1 Stories Height
Foundation ie
Class of Const. 6 Occupancy Permit U
HEATING CONTRACTOR /aiLf.�(! e-41
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR 4---0 Z;
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR d f 4
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
#D 6(14 f /e) 0 d 7
FEES: Valuation o, 000 .00 Permit Fee Paid Park Dedication 00, 0 0
ISSUED BY D Date o�S�g z Final /O.P. //I 0 02
In the performance of this work I agree to perform all work pursuant to rules governing the described construction. 4::r:/0,4 SIGNATURE r_ /0
AGENT /OWNER DA E
ADDRESS
TELEPHONE
LI 89 Q8 9z/�
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM
Labor &Human Relations BUILDING PERMIT APPLICATION NO. )0O) 4
Division of Safety Buildings
Box Madison, W
I 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
ERMIT RE ESTE
CONSTR UCTION HVAC ELEC PLUMBING OTHER:
Owner's Name Mailing Address Telephone
Co ractor's Name Mailing Address Telephone
co& (i ut� Z 6 d a g /-‘00,
L ot Area
0 T..
Sq. ft. /a, SECTION T N, R E (or)W
Building Ads;s r� Subdivision Name r Lot No. Block No.
Zoning District(s) Zoni Permit No Front Rear Left Right
e Setbacks ft. 7...r ft. ft. 6 ft.
EC :ii :ii:>::
::�i V:.:::<E >9R tt#!llG;�IE�I�'.;;:::
ENERG�f
SOUR�..
}otv Repair Sin Family Entrancg Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
''❑❑Alteration Raze Two family Size: l amp Radiant Baseboard or Panel `Gas
Addition El Move Garage rvice: 1:1 Heat Pump SPace m9• J"'- El El
Other derground Boiler Water Htg. W
Overhead Central Air Conditioning
Other RE FOUND k IO Other 0 Dwelling unit will have 3 kilowatt or
more installed electric space heating equip.
Concrete Infiltration control o
ite constructed #1:`<<L#llf<'< option is: Full sealing
p
Manufactured Masonry Sewer of joints. Blower door test. Exterior
Treated Wood X Municipal air infiltration barrier.
Other Septic c
Unfinished Basement 1 (I04 Sq. ft.:: I''# ��I?< c V:::: P t No.
7. 5.. 1� '1'..Lttr:.�Calculstedl«<:
Permit
Living Area I/O T Sq. ft.
2-Story 1-Story Envelope 2 -2 lo'( BTU /HR
2-
Seasonal Infiltration 6Z.L. -r`f BTU /HR
9 i° q ermanent
Garage S ft. Other Municipal Utility 1!��?�T$II~C
Other ty
Private on -site Well e�
Plus basement r�l
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 Departm nicipality; and certifies that all the above information is accurate.
SIGNATURE OF APPLICANT 7 DATE D
CONDITIONS OF APPROVAL This permit ist issued pursuant to the following conditions. Failure to comply may result in suspension or
revoca o f th permit or other penalty.
4:4 .acY -7�-6 _a/. l/
1z".Pfd-"'- ❑TOWN VILLAGE CITY COUNTY Municipality Number of Munici alit Number of Dwelling
:i:ORLSENCTIONN nu
STAT INDEPENDENT Inspection Authority Location, if different
YIfIS;:JNIFORIIt PSRliiltt..
Plan Review 70.0 0 Construction I-
HVAC NAME
Inspection Electrical 'Z
Wis. Permit Seal, O Plumbing DATE Z
Other Other S-TD
TOTAL 70.00 CERT. NO.
SBD5823(R.8 /90)ao WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK— Owner /Agent
Revised:8/es
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: ZONING: rr
PROPERTY OWNER /CONTRACTOR: /L--( (20
CONSTRUCTION DATA: SEW CONSTRUCTI{N ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
lip,/,) W 20 xz- f 7 0 h. si.
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (fraTt 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 Jl
REVIEW AUTHORITY: L/_ G
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.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Requi ed c
REVIEWED BY:
OP DATE 8 5' Z_
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DATE 4A
NAME /a64? &GIC ADDRESS
LOT 3 7 BLOCK WARD
SUBDIV. be,b42:1-e-43:4 ZONE
STREET NO.
LOT DIMENS
SIDEWALK EXISTING YES NO [E]
BUILDING GRADE ELEVATIONS STAKES SET AT SITE ,I9 9 BY
FEE :$10.00
I1 S
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree ro have the
grade established before excavation has commenced.
00 a-S-36
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /Z73 lit 4
Owners Name eg rr4Z 1
Name of Subdivision 7,/1 �.,4yyrw
Lot 37 Bldg. Permit 300 V
No. of Units 1
Fee Required 0 0 .r9 0
Fee Paid 0 o o 0
Owner's signcture C%r// Date 8//
Inspector's signature Date Ff O7z—
Parks Subdivision
Improvement
Accts. Rec.: 362 -041