HomeMy WebLinkAbout0040776-Building a-
CITY OF OSHKOSH N� 40776
PERMIT APPLICATION AND RECORD
TYPE: BLDG
X HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 1 3? WgE4 J l,(hly PLAN NO. F& —c/ —2
901f
OWNER SCN
DESIGNER �,Q n
US ATURE OF WORK ��AJ n'1 f 4 i7 qc Vv' �V�6
�rto (,C-l/ (:cx�o L 2/eZ. O,oEi// /5� Z
(vvsE 9 AE Ya -5 /n06 Lt ?,/o e oiCm%6 /S
BUILDING CONTRACTOR USCH
Size Sq. Ft, i a/ Rooms -3 M Stories Height i
Foundation Class of Const. O ccupancy Permit 4P
HEATING CONTRACTOR
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR �M /A.,S
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 5'/"!7
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 Permit 6C
Park r
emit Fee Paid $Park Dedication /CO
ISSUED BY Date 9/o2 My Final /O. P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DA
ADDRESS
TELEPHONE
5054 (*)b2) Fes I 11A4 P
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations BUILDING PERMIT
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)
:PER IT RE U T 't ,wi
t� Constr 0 HVAC Elec 0 Plbg Erosion 0 Other:
Owner's e Mailing Address Telephone No (include area code)
kti4 7 0;12 t. G 2 766 W.1 trn a3 R Z63
Contractor's Name Mailing Address Telephone No. (include area code)
Lot Areea
.AT 58 1/4, 1/4, Section T N, R E (or) W
Building Address t Subdivision Lot No. Block No.
79 w ao 1.1/41 ()Jo Na 7 ,0 i I1
Zoning District(s) Zonin Perm No. y Fr ont Rear Left Right
Setbacks 95` ft. 53 ft. 10'6" ft. Q r lo 11 ft
T: fEC'#>`. >1: CEfFiflt ELEC7RICAt... ':3::> 1lACE.< tFMIEISkT< .S01
slew Repair ingle Family Entrance Panel B o ced Air Furnace Fuel Nat. L. P. Oil Elec. Solid Solar
Alteration Raze Two Family Size: 106 amp Radiant Baseboard or Panel Gas
Addition Move Garage Ser ice: Heat Pump
Other (print): 1Jnderground Boiler Space Htg
Overhead Central Air Conditioning Water Htg
Other Other Dwelling unit will have 3 kilowatt or
re more installed electric space heating equip.
ite Constructed oncrete Infiltration control option is 0 Full sealing
Manufactured M
asonr Y of joints. ❑Blower door test. ❑Exterior
]:2VAR A:tNV :VED Treated Wood Sewe air infiltration barrier.
�5 R ES Other unicipal
Unfinished Basement 576 Sq. ft. S e t
1 Story isi: :H �tt T: S c r ft;liMid..
Living Area 110 y S ft. Permit No. Envelope e BTU /HR
-Story Se onal
..1 z< :z I nfiltration 1 o BTU /HR �7
Other ermanent 3/ 7
Gara a �O S ft 9
q
I
u
nia a Utility
❑Other Y
ILs Basemen Private On -Site Well Sa UO O
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, pn the D ment r municipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE 7:47%.,.. i DATE SIGNED 7/26/f1
APPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalty.
1•) /N5r4c.c„ c3. 6 /Z4 &S /LH/L 2/. /2...C-
Town Villa i
Village C t Count State of: Municipality Number of Dwelling Location:
CI 9 Y Y P Y
9
JUR ICTION 70 ea 6
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Plan Review S. n T struction
Inspection HVAC Name 1L-4– 9=049J,—,
Wis. Permit Seal Electrical
Other Plumbing Date 2
rosion ',per{ Li
Total -_s q V Cert. No. QVQ
SBD -5823 (R. 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
YS,000
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: wi L\CI ZONING
PROPERTY OWNER /CONTRACTOR: QJR G Je octh
CONSTRUCTION DATA: X New Construction Addition Alteration
TYPE OF CONSTRUCTION: (Le. fence, pool, parking lot, sign, etc.)
11
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 /00
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: ti DATE:
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DATE 7-1a 31 ct4
NAME I�lZ ADDRES S
LOT 1 I BLOCK fARD
SUBO I V .�-{-I Q4 tI' ZONE
STREET NO. l r r1 LLA 0.1.4 LOT DIMENSIONS
SIOEWALK EXISTING YES NO [:=1
BUILDING GRADE ELEVATIONS STAKES SET AT SITE ,19 BY
FEE; $15.00
t)s
Tangy,
DEPARTMENT OF PUB (C WCRK_
I, the undersigned, owner or agent of the above described property agree to have the
grade estaaiished before excavation has commenced.
Gcxre f4,
City Of Oshkosh 1/1/85
PARKLAND DEDICATI ON FEE Lch ON RECORD
Address 079 79 Whn
Owner's Name PC).--)/
Name of Subdivision 1,00a o VI Fe2
Lot /I p Bldg. Permit q$0
No. of Units
Fee Required S/00
Fee Paid cc
Owner's signcture Date g Z cf
Inspector's signature IJIIIIMPIF Date I
Parks Subdivision
Improvement
Accts. Rec.: 362 -041