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HomeMy WebLinkAbout0036381-Building rt 3 CITY OF OSHKOSH N2 36381 PERMIT APPLICATION AND RECORD TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT ADDRESS t W E}ttFkE VV 7kA PLAN NO. Fl /4 OWNER 11`Q= Q4R\K DESIGNER USE /NATURE OF WORK 1\1EVN S IOrz.._E TAryt A-r Goki/p\& BUILDING CONTRACTOR SA 1�GQ Mt\S Size Sq. Ftt. iao Rooms 4:: Stories Height 1 R tl Foundation 0,MCREVE Class of Const. Occupancy Permit HEATING CONTRACTOR Heat A/C Vent Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR C r' r n -C„- Electric Serv. New Change Temp Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR C k A 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 Fee Paid 1 ©p €30 Park Dedication /w' (119 ISSUED BY .Wt Date kOt 14 [C( Final /O.P. In the perform nce of this work I agree to perform all work pursuant to rules governing the described construction. S GNATUR' e /v 3 r .WNER DATE DRESS) I TELEPHONE F/ /64 /qq3 R /./';'44t9/24J Wisconsin Department of Industry, WISCONSIN UNIFORM Application No. Labor and Human Relations BUILDING PERMIT g6331 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) .iS o n str VAC let Plb Erosion fir' 9 Other: Owner Name Mailing Address Telephone No. (include area code) X 5 7(A) Q. 0 3 Contractor's Name ;071q6 Mailing Address Telephone No. (include area code) ea Sq. ft. 1/4, 1/4, Section T N, R E (or) W Buil d' .`P 'I d d dres ,4 Su div ion Nam y LO/ Q�Q. Block No. Zonin istrict(s) Zoning rmitNo. Fro t Rear Left Ri h 9 r G fl Setbacks ft. ft. ft. ft. ;1 New Repair ingle Family Entrant P nel forced Air Furnace Fuel Nat. L. P. Oil Elec. Solid Solar Alteration Raze II Two Famil Size: Addition ❑Move y amp ❑Radiant Baseboard or Panel Garage Service. Heat Pump Ht Space Other (print): Underground Boiler P g ❑Other Overhead Central Air Conditioning Water Htg t i O unit will have 3 kilowatt or Dwelli e g u ni more installed electric space heating equip. ite Constructed oncrete L M g P' ���1�i Infiltration control i F option o s Full sealing Manufactured Masonry ew of joints. Blower door test. Exterior Treated Wood Sewer air infiltration barrier. gi:# ;i Other Municipal Unfinished Basement 1-2:2.C. Sq. f ❑septic >�.T..:'.� *1 -Story a: S Permit No. 1. f Area ?..0 S ft. Envelop BTU /HR Living q 2 -Story Seasonal Garage 1-10 5 ft. Otherermanent j >s >z's Infiltrati BTU /HR g q. Municipal Utility P Other •,j''::''`' Plus Basement Private On -Site Well •ti' d ...r The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; und(rstands that the issuance of the permit creates no legal liability, express or in 'e the Department or municipality; and certifies that all the above information is ccurate. APPLICANT'S SIGNATURE DATE SIGNED /D j APPROVAL CONDITIONS This permit is issu'Isd pursuant to the following conditions. Failure to comply may r ult in suspension or revocation of this permit or other penalty. i•) .)ern it crRits TRaios Town o Village e it Coun State of: 9 Y e o Municipality Number u T Y p of Dwelling Location: JDt€IO� 2.6 G s soil•.:. i Plan Review y(0o Construction k Inspection HVAC Name Wis. Permit Seal 50. Electrical OI �y Other Plumbing Date Total a ex, Erosion 13t y D f 1:1 Cert. No. b SBD =5823 (R. 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner/Agent Revised: sis ZONING /LAND USE COMPLIANCE CHECKLIST JOB LOCATION: ak) C L A E X I E b A ZONING: LL____ PROPERTY OWNER /CONTRACTOR: e .i Ci CONSTRUCTION DATA: NEW CONSTRUCTI{IV ADDITION ALTERATION PARKING LOT TYPE OF PROPOSE CON TRUCTION: (i.e. fence, pool, sign, deck, etc.) N 3 ■NGL� V,A,c�.\ 1..)..y` o k-'yN. N CAS: 1:' 44 --2- M (CAE=. 14 COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT DEFICIENCY /COMMENTS Use Lot Width Lot Area Floodplain Front Yard Side Street (from 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 REVIEW AUTHORITY: o--16 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. LPPROVED DENIED Plan Commission Action Required Variance(s) Required REVIEWED BY: 0 DATE: 5' 1 1• 1 1 :i.: :i ..I t'! ''••!'..ff :ill; 11 II 1 i I ,Z it 11 i I II,..,.! 1 11 H11 1 .10 11 1 1 11 WWI 1 111 11 I 1 (..):Z I 1 1 II 1HII 1' M I■4i I i i i 1 1 I I i 1 i I i I I i i 1111 1. 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IIiIii>1 II!!!• --2 •I .I HI• II;11111!Ii1 Iiii'i i.; '1 !1 H ii;11.'-'1,e/.H+';:. .1: i,:• Iiiii 1, li;I I 1: 1 :1 it •I'.,■..;.1..ii, ;1.;:in'','.. II'•'1,i't.I'' ',ii4.i11111 1 11 1 ".;illi II 1 1111 1: i 1,).'1''..ii 1 !'I •ii IiIiI11 :i i' I ii. 1 i 11111 iHit .:I l',111:1!, 114':11: :11, 1 1! I •1' 1' 1,1;11 ',ill!!! '1 11.7i;:1,;: ,,i 1, :•,:j .II•1 HI 1 11111:111Wil 1 I IIIHI 4 •:,1 'Iii.I.!:'• s.'1I111,111,1 11 1 IIiii !I '1!I:I!': 1 CATE 10( NAME i'_!__,� tom, .�-b1 ADDRESS LOT 1 BLOCK WARD Am d Gt day✓ SUBDIV. W 6K '5.,( ZONE STREET NO. (e 4 LOT DIMENSIONS SIDEWALK EXISTING YES 0 NO a BUILDING GRADE ELEVATIONS STAKES SET AT SITE 0 ,I9 BY,,,,-. f FEE; $15.00 7 e 7; LartiActe,c.a,63- DEPARTMENT OF PUBLIC WCRKS I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced. JA ,4„..4.- 00/1.952 z/-77 City Of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address i D w EL w Owneras Name `s-. Cli of Subdivision Ell- W.R.IA Lot V3 Bldg. Permit 38 l No. of Units t Fee Required 4 100 Fee Paid 4D Owner's signature Date Inspector's signature Date 1 D) N I R3 Parks Subdivision Improvement Accts. Rec.: 362 -041