HomeMy WebLinkAbout0038037-Building PO
a CITY OF OSHKOSH N 38037
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 199 WhigetAid Ldc PLAN NO.2 i O /g
OWNER N (/O61bAJ
DESIGNER
USE /NATURE OF WORK U r' 'f ,I- 4 fAc r 2"4 6:
BUILDING CONTRACTOR O>� 3
Size iag Sq. Ft. Rooms A- 4g Stories Height U
op i
Foundation /k.r.-12E Class of Const. R Occupancy Permit 4L a
HEATING CONTRACTOR f eerOL
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR G2/11(1/7 69JeLs
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 7Y
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 w TT Permit Fee Paid Par k Dedication i ISSUED BY 11L�':,,/ Date /i46/Q Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /241__ z Z
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AGENT /OWNER DATE
ADDRESS
TELEPHONE
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Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor Human sDivons BUILDING PERMIT ?P(753'-F
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)
:PE`'E TED
nstr VAC ErElec `Ib osion
Lam' 9 �C- Other:
Owner' ame Mailing Address Telephone No. (include area code)
Vi n 0276 6 JD. *.ani iy 23/ 3 Lag
Contractor's Name Mailing Address Telephone No. (include area code)
>:>E:: Lot Area
5026 Sq. ft. 1/4, 1/4, Section T N, R E (or) W
Building Address Subdivision Name Lot No. Block No.
/a 4 y w u1 uzza r ii. Q� yo
Zoning Districts) ning Permit No. ront I Reaa Left Right
«1��� Setbacks �5' ft-J �l ,r..`..ft: q/0/ ft. '6 r` ft.
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y :..i•::::: J�... i..�i.. \y;y�: :�Mi::ii:::�fii �7��'�4` +�I L:: ���il �I�:, i? iiY.}: :i ::•:;:::•i:•::•:4•::i:_ii
Rivew Repair Ingle Family Entrance Panel orced Air Furnace Fuel Nat. L. P. Oil Elec. Solid Solar
Alteration ❑Maze Two Family Size: (00 amp Radiant Baseboard or Panel Gas
Addition Move Garage Serf e: Heat Pump Space Htg
❑Other (print): &Underground ❑Boiler
Overhead Central Air Conditioning Water Htg
Other ❑O ❑Dwelling unit will have 3 kilowatt or
more installed electric space heating equip
Crete P 9
ite Constructed C
108iNG »s #`•z� ON Infiltration control option i Full lin
Manufactured n P s u sealing
❑Treated asory Wood of joints. Blower door test. Exterior I
Sew air infiltration barrier.
Unfinished Basement ��ff�� 2 S•:..:....: •s:' »iii'Mi
_16�q-ft• 4 0 uniupal
Septic !1!IM M TtOSSIOai itit
1- Story i.:Igi 'i <iiiai Permit No. Envelope BTU /HR
Living Area y Sq. ft. Vory Se al A P UWA i E i< i>; ?<iii ::E ntraton r ermanent Infiltration BTU/HR
U
Garage 1 W Sq. ft.
B�
unici al Utility P
Qa.�/� ❑Other Y �x: �WCOSX::.
(plus Basement Private On -Site Well y, //y n 6 p
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; un(ierstands that the issuance of
the permit creates no legal liability, express or lied art ent or municipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE 1�,. DATE SIGNED 02//5/7y
APPROVAL CONDITIONS This permit is issu'Ld pursuant to the following conditions. Failure to comply may result spension or
revocation of this permit or other penalty.
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Location:
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Name :.:.g:.::::
Plan Review i Q (jZConstruction /m 5 Fi•
Inspection HVAC
Wis. Permit Seal Electrical a 1 161
Other Plumbing Date
Erosion �,e�
Total 1 air Cert. No.
SBD -5823 (R. 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
SC cc
Revised: E/S
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: /91 WtJ T/ FE7 m ZONING: /A
PROPERTY OWNER /CONTRACTOR: �USC? C 6/0 UCT7Q
CONSTRUCTION DATA: EW CONSTRUCT0 ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONS CTION: (i.e. fence, pool, sign, deck, etc.)
A E b o S j v 6 1 6 7 /(L 4 1 7 7 4 4 6 2 6172/t
925 R N yI4S
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (t t yard)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per Family
Corner Lot
Landscaping elan VA Z
Transitional Yard
Off-Street Loading
Vision Clearance
Height
REVIEW AUTHORITY:
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) Required
REVIEWED BY: /s 111 III
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GATE j 2/4
NAME H COADCO)
ADDRESS
LgT
9 BI,CCK
sueolV. 1A1�� ,�s
ZONE
STREET NO. 7 I LOT 0 IMENS IONS
SIDEWALK EXISTING YES
NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 1
19 221__9Y el'J
FEE $15.00
OEPART "ENT (C 'WORKS
I, the undersigned, owner or agent of the above described property agree ro have the
grade established before excavation has commenced.
L
OT",1.932 6 P \l/
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /&9/ W /TF/ I� /P
Owners Name 7) C
Name of Subdivision tt 4 �CI��✓
Lot O Bldg. Permit _3.750E?
No. of Units
Fee Required cg /COQ
Fee Paid fr f00d
Owner's signature L--. 'A Date
2 z7
Inspector's signature s r d, Date �l
Parks Subdivision
Improvement
Accts. Rec.: 362 -041