HomeMy WebLinkAbout0038589-Building N°_ 38589
CITY OF OSHKOSH
PERMIT APPLICATION AND RECORD
TYPE: BLDG] HTG ELEC PLBG SIGN
y ZONING FLOOD PLAIN HEIGHT
ADDRESS aTi. W "t)3S ��`1 1
PLAN NO.
OWNER
(---4,) Q 1 CZA 71 -�C)
DESIGNER
USE /NATURE OF WORK th L� A \.14.A. 1 A k z
BUILDING CONTRACTOR Q..-kk
Size 1 4t- Sq. Ft. toy
Rooms G'a Stories G? Height 1
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat A/C Vent Fuel /System Heat Loss
BTU'S
ELECTRIC CONTRACTOR GLDRAN\ t
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 0-) A-
BT WH Disp 1 WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation S d Permit Fee Paid S
f Park Dedication 7c.r
ISSUED BY l iAl Date /7 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE AA_ i 3A S y
AGENT /OWNER DA E
ADDRESS
TELEPHONE
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations BUILDING PERMIT 3
Safety and Buildings Division
P.O. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
Wisconsin Statutes 101.63, 101 73 (See instructions on back of pink copy)
PERMIT REQUESTED nad 1 A 4,4rosion Other:
Owner' a Mailing Address Telephone No. (include area code)
'A C. -41.Q J-74:in L &tea s Telephone
,2, 3/ 326
Contractor's Name Mailing Address No. (include area code)
PR L C A ON Lot Area
R 7 Sq- ft- 1/4, 1/4, Section T N, R E (or) W
Building Address Subdivision Name Lot No. Block No.
1 W /LeaJit L p 4, rvt., 1/ F
Zoning District(s) oning Permit No. LJ�� f Rear Left Right
Setbacks c. 5 ft. 5 ft 16'6 r ft. /0'6 ft
1• OJECT :3 'CUPANE.Y 9.. AC:E:+ IPM.ENT .:.1:2.. ENERGY OUR
L! ew Repair ingle Family Entrance Panel L' orced Air Furnace Nat. L- P. Oil Elec. Solid Solar
Alteration 1=1 Raze Two Family Size: (O amp Radiant Baseboard or Panel Fuel Gas
Addition Move Garage Ser ice: Heat Pum
Other (print): Underground Boiler Pump Space Htg
Overhead Central Air Conditioning Water Htg
Other Other Dwelling unit will have 3 kilowatt or
QT R more installed electric space heating equip.
Site Constructed (PConcrete 4> PLIJM$ING Infiltration control option is Full sealing
Manufactured Masonry
Se
air infiltration barrier of joints. Blower door test Exterior
❑Treated Wood
Unfinished Basement 'if/ Sq. ft. STORES Other unicipal
Septic H 'LUST (Cacuafied)
y 1.� 1 Story Permit No
Living Area Sq. ft. 2 �th Story S ermanent
sonal Envelope AD, e BTU /HR
S LK W Infiltration J p' '93 .06 BTU /HR
Garage �(O Sq ft CY
Other [lunicipal Utility EST
Plus Basement Private On -Site Well 4/5,7600
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, express or implied, on th p rrtmee t or municipality; and certifies that all the above informati n is accurate.
APPLICANT'S SIGNATURE DATE SIGNED 3 2,
APPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may result in su ension or
revocation of this permit or other penalty.
1. 1 fV3 ACC, G 1' /14Gi SU26F 5 L /alle 0,/02..c
.5- bane /r 77T�s ?a c.S,
tS$UING Town Village 9 County State of Municipality Number of Dwelling Location:
uRIsIICTl+r
Plan Review 0 aQ onstruction
Inspection H C Name Q.kA J"t
Permit Seal Electrical
Other Plumbing
Date
Total rosion 4 (DI Cert. No.
SBD -5823 (R 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
3Soob
LS, 1 Iq NtB. 'ik s
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: e c ZONING
PROPERTY OWNER/CONTRACTOR:
CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
COMPLIANCE CHECKLIST
DEFICIENT COMMENTS
Use
Lot Width
Lot Area
Lot Area Per Family
Floodplain
Front Yard
Front Yard Side Street
Rear Yard
Side Yards
Building Area
Parking Standards
Off Street Loading Standards
Vision Clearance
Transitional Yard Standards
Landscape Standards
Height
Conditions of Approval
Compliance with P.C. or
BZA Conditions of Approval
Signage Standards
Drainage Plan
REVIEW AUTHORITY
As per Section 30 -5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or
designee, must approval 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.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: DATE:
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CATS I QD\ q
NAME o,. ADDRESS
LOT 119 BLOCK WARD
S 0801 V L 1 Lc\ 'k z. ZONE
STREET NO.�P \LOT DIMENSIONS
SIDEWALK EXISTING YES NO wa
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 31 2- 19
BY
FEE: $15.00
*CP-41
OE ARTMENT OF P U B L I C WORKS
r
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
ti
a l o„,„D,5;_s o
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address 13 Lo FiE L L5g
Owner's Name SCJ� l
Name of Subdivision (,0697L& i4I2j4 S
Lot I q Bldg. Permit
No. of Units
Fee Required lopa
Fee Paid 00),
Owner's signature Date 3 1' 8 97
Inspector's signature AIWIL Date 3/0
Parks Subdivision
improvement
r",ccts Rec.: 362-Th