HomeMy WebLinkAbout0070289-Building CITY OF OSHKOSH No 0070289
OSH r OSH BUILDING PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 1922 OHIO ST Owner SUSAN R LLOYD Create Date 5/24/99
Designer Ross Designs Contractor SALZER SIDING 08/02/99
Category 110 New Single Family Plan C7- 069 -599R
Type Building' O Sign 0 Canopy o Fence 0 Raze
Zoning R -1 Class of Const: 8 Size 34' x 64'
Unfinished /Basement 1024 Sq. Ft. Rooms 4 Height 19 Ft. Projection
Finished /Living 1024 Sq. Ft. Bedrooms 2 Stories 1 Canopies
Garage 440 Sq. Ft. Baths Z Signs
Foundation Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupancy Permit Required Flood Plain No Height Permit Not Required
Park Dedication Not Required Dwelling Units 1 Structures 1
Use /Nature NSF-t/ New Single Family Residence with attached garage, and concrete patio.
of Work
HVAC Contractor AMERICAN HEATING A C CO Plumbing Contractor WELLNITZ PLUMBING
Electric Contractor SECKAR ELECTRIC
Fees: Valuation 61,000.0 Plan Approval $40.00 Permit Fee Paid $257.50 Park Dedication $0.00
ISsued`By Date 5/24/99 Final /O.P.
0 Permit Voided
In the performance of this work I agree to perform all work pursu- -t to rules governing the described construction.
Signature Date J
L nt/Owner
Address PO. BOX ':825 OSHKOSH WI 54903 0 Telephone Number 231 -5025
OSH OSH GRADE STAKE FORM
ON THE WATER Grade Stake Number 6170
Name SUSAN R LLOYD Address 1922 OHIO ST Create Date 05/24/99
Lot 20 Block 11 Ward
Subdivision Powers Smiths Zone
Street Number Lot Dimensions 50' x 135.97 Sidewalk Existing
Building Grade Elevation Stakes Set At Site 00 /00 /00 Set By
Department of Public Works
I, the undersigned, owner or agent of the above described property agree to have the grade established before exc vation
has commenced.
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Wisconsin Departmentoflndustry, WISCONSIN UNIFORM Application No.
Labor and Human Relations
Safety and Buildings Division BUILDING PERMIT 0070289
P.O. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
Wisconsin Statues 101.63, 101.73
E a Constr 0 HVAC 0 Elec 0 Plbg Erosion 0 Other:
i s ame Mailing Address Telephone No.
SUSA R LLOYD 7042 HOWLETT RD OSHKOSH WI 54901 0000
contractor:® Con [3 elec 0 HVAC0 Plbg Lic/Cert Mailing Address Telephone No.
SALZER` 011/1/2/VW 7351 PO BOX 825 OSHKOSH WI 54903 0000 231 -5025
Contractor.❑ Con a Erec0 HV AC Plbg Lic/Cert mamng Aaaress i eiepnone No.
SECKAR MIL, I rni 1302 CONGRESS OSHKOSH WI 54901 0000 231 -2237
t,ontractor.D Con ID Elec HVAC J Plbg Dc/Cert malnng Aaaress i eiepnone No.
AMERICAN NtA I INU es, A t;u 1129 MICHIGAN AVE OSHKOSH WI 54901 0000 235 -8090
'Contractor:El Con 0 Elec HVAC Plbg Lic/Cert Vtaiung Aaaress I elepnone No.
WELLNITI I•'LUMISINU 223819 4810 AMBERWOOD LN APPLETON WI 54915 0000 749 -1091
Lut Aiea Sq. ft. 1/4, 1 /4,Section ,T N,R E(or)W
ui mg ress Subdivision Name Lot No. Block No.
1922 OHIO ST Powers Smiths 20 11
Zoning District(s) zoning Permit No. Front Kear Lett Hight
Setbacks ft ft. ft. ft.
b_•
�x�- _e.. .�..a: !e.!!w�. z. "i. ...e i s R a`�:: e e H i e e eO•OOi i i•::'
...r.., ..Q.E.e._e ._..•.e�a�H.i.n....S.... ..neSe:•!•'•'.S!.A:.AA•SA!
New El Repair Single Family n rance ane Forced Air Furnace Fuel� o ar
Alteration Raze al Two Family Size: 100 amp Radiant Baseboard or Panel
Addition Move ■Garage Service: Heat Pump Space Htg 0 0 0 0 0
al Other (print): Overhead Boiler Water Htg 0 0 0 0 0
Other i Underground Central Air Conditioning
I a E�� Other Dwelling unit wil have 3 ki owatt or
more installed electric space heating equip.
Site Constructed Concrete
c :i .1 i ifi,. Infiltration control option is Full sealing
Unfinished 0 Manufactured Masonary Sewer of joints. ri Blower door test. 0 Exterior
Basement: 1024 Sq ft I[F
Treated Wood Municipal air intiltra ion barrier.
Other
Living Area 1024 Sq. ft. 1 -Story Septic
Garage 440 g ft 2-Story t.. a. ......t.M.:._: Permit No. Envelope BTU /HR
q Other easonat Infiltration 14100 BTU /HR
a Permanent .x r
Other Municipal Utility
Plus Basement Private On -Site Well $75,000.00
The applicant agrees to comply with all applicable codes, statues 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 Department or municip. nd certifies that all the above information is accurate.
APPLICANT'S SIGIVATURE��,���� DATE SIGNED G t /L j
APPROVAL CONDITIONS 1 his permit is issued purs nt o the l o,� t ;tritons. Failure to comply may result in suspension or
revocation of this permit or other penalty
1 Town Village City r County State of: Municipality Number of Dwelling Location:
t i:: City Of Oshkosh 7 0 2 6 6
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O° is __y _„y_ :.0•i:: :1: i :1::::: 0:::00. x i•. i Nx.
Plan Review 40.00 g Construction
Inspection HVAC Name Brian Noe
Wis. Permit Seal $30.00 Electrical
Other Plumbing Date 05/24/99
7 Erosion
Total $70.00 221263 Cert. No. 70266
SBD -5823 (R. 07/92)
rJ51-i' OSH PARKLAND DEDICATION FEE COLLECTION RECORD
ON THE WATER
Job Address 1922 OHIO ST Date 5/24/99
Name SUSAN R LLOYD
Address 7042 HOWLETT RD OSHKOSH WI 54901
Subdivision Powers Smiths Lot 20
Building Permit Number 0070289
Number of Dwelling Units 1 Number of Structures 1
Fee Required $0.00 Fee Paid
Owner's Signature i Date 1''2/ 99
Inspector's Signature F.
Date `,5 Z
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