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HomeMy WebLinkAbout0036384-Building go CITY OF OSHKOSH N9 36384 PERMIT APPLICATION AND RECORD TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT ADDRESS mg W H T6ELb 1AI Al/ PLAN NO.(r V /0 OWNER gi.) cfi1 CarrROCMNI DESIGNER NA USE /NATURE OF WORK k ?AJ L rnity bums' 1 47-mc .,7 /2R6& BUILDING CONTRACTOR N Size Sq. Ft. rUSC.- Rooms 6- s gC Stories Height 7 Foundation 0o4t2EriE Class of Const. 8 Occupancy Permit ____y____ HEATING CONTRACTOR e Heat A/C Vent Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR I1t/14t11//UPS Electric Serv. New Change Temp Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR il' 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 3 0 C Permit Fee Paid Park Dedication ISSUED BY Z'tii S7 L j Date /0 /f S/ p Final /O.P. In the performance of this work t agree to perform all work pursuant to rules governing the described construction. LIGATURE 771- D gl g3 L�N�: Y�. WNER C.�. ADDRESS 2 f3 TELEPHONE r\ IcAct3 Wisconsin Department of Industry, WISCONSIN UNIFORM A pplication No. Labor Human Relations BUILDING PERMIT 3� �y 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) ST Constr NHVAC Elec 9 PIb Er oslon El Other: W Owner's N Mailing dress Telephon (include rea code) .7GV��� X3/..3 Contractor s Name c o47ne.... Mailing Address Telephone No. (include area code) >:::'.E Lot f r ?::::p.::.R F�` i a (�t/ Sq. ft. 1/4, 1/4, Section T N, R E (or) W Buildin rte/ C/ s ubd is me 9 +f�' c 5 0 1 rl�'as Lot Block No. V/11 q Zoning District(s) Zoni Permit No. Front R r Le e Right, /J Setbacks J S ft. ft- 6 ft- 4 New Repair NI ingle Family Entran nel Nat. L. P orced Air Furnace P il Oil Elec. So So ..li lid d Solar ❑Alteration ❑Raze Iii Two Famil Size: Fuel o Addition ❑Move y amp Radiant Baseboard or Panel a Garage vic Heat Pump Space Htg Other (print): Underground Boiler Overhead Central Air Conditioning Water Htg ❑Other Other Dwelling unit will have 3 kilowatt or ore installed i nsae electric space heating iteConstruded "'y�"��'.#''s� �y"�•"'�+ P equip. f PL U BINRii`, iE Infiltration control option is: us lin anufactured ❑Masonry Full sealing P of in ❑Treated Wood e r 10 is Blower door test. ❑Exterior air infiltration barrier. Unfinished Basemen >s Other M unicipal S q ft. �y`y]r� Septic HE r Living Area 0 Sq-ft- 1-Storry iOSE •...:..•.•.•.•..•......i.• Permit No E BTU/HR �;1 f1 Y Seasonal Envelop fl AA'f c! >;<`r[ Infiltratio prod >4 BTU /HR Garage S ft. ❑Other �ermanent �J g q- Municipal Utility Other Plus Basement Private On -Site Well 36i dse� The applicant agrees to comply with all ap able codes, statutes and ordinances and with the conditions of this permit; undettands that tt the issuance of the permit creates no legal liability s o i pli on the Department or unicipality; and certifies that all the above information is accurate. APPLICANT'S SIGNATURE DATE SIGNED /b -ly 3 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. t1 ,R s g.t T own Villa e Cit Count u t State f: 9 Y o Municipality Y a t Number of Dwelling >I�.. P Y Location: ii Name s: Plan Review F� construction r_ Inspection HVAC Y� (Q.b- Wis. Permit Seal S °d Electrical Other ❑Plumbing I b2 Date 1 PErosion Cert. Lk bb Total 7L/ SBD -5823 (R. 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner/Agent Revisal: 8/S ZONING /LAND USE COMPLIANCE CHECKLIST JOB LOCATION: 12%, L)€ (A)WE.: C.124 A ZONING: PROPERTY OWNER /CONTRACTOR: t -k -k- L t CONSTRUCTION DATA: EW CONSTRUCT�N ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.) NSW kTA .A Gi1/4 Ptoo`l 1/ 36 4)-i- (436:ce 4/1/D4 COMPLIANCE C1 (Check only those applicable) ,,,:=:'2,:*„:::. ri COMPLIES DUI I DEFICIENCY /COMMENTS Use 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 RE'1I AUTHORITY: ,2L...--! V The Director of Community Development, or d e, must approve all plans, except the folio ing: (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. C/AROVED DENIED Plan Commission Action Required Variance(s) Requir REVIEWED BY GATE: `Q/l0/ l''' —1 "'ll I I 'tit 1: i i 1 1 1;,.- •I'l .t II 1 1 1 1 II. t 1 1il 1 i.1 1 I "'!Hli I Li f! III I i 1 1 ,i'It ■1 I I iii i 1, 11 i, i•.• i'• •t 1 I i t il I 11 1i 1!! 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I I 11 1 1:1 +1; 1111,I 1 I11 Wit IIII:WHII (q 1I 1 IL. 1 ,;111:1!1,111 t;;;; ;i 2•.(zi IIIIIII 1111 ItWit1I.1 1 it•;:;•::t 1 s l t 1 tit,t1,1titt .111 II 1 i l 1 I„::: ;1';IHIII, I:I WW1 I. 1 11 WH I11111':111 ;:t :111,- 11:;;; ,11:111111! '0 'I''.; ''9;1; 1; I. ttt,;! 1!:, if, i ''i I■ HI '.ii ''''''li I CATE NAME Gf\B ADDRESS LOT I H BLOCK SUED I V L 3 v E\b rz ZONE STREET NO. 1a% U e1& S OT DIMENSIONS SIDEWALK EXISTING YES L NO a BUILDING GRADE ELEVATIONS STAKES SET AT SITE O c /1 ,I9 7 BY o 6-4A-'' FEE; $15.00 G OEPARTMENT OF PUBLIC WORKS I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced. i 00'1855' o fi/4 stsr cn 7 c frs7 F- //4-7,7 City Of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address NY6 /i) i fiez1) I,(M Owner's Name LUSC (ijLr7 Name of Subdivision Vt/&s✓ C 6V 1, Lot Bldg. Permit 368y No. of Units Fee Required ff c Fee Paid /(O Owner's signcture 9 Date C1 I y- 3 Inspector's signature 4 ,w Date /0 5/7$ Parks Subdivision Improvement Accts. Rec.: 362 -041