HomeMy WebLinkAbout0038035-Building CITY OF OSHKOSH No 38035
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS I S C 1 I \I;& BEU \N)Pr3 PLAN NO769 CAC
OWNER Tl 'C t
DESIGNER
USE /NATURE OF WORK }tiq GARPic„e- W ..E l k`
BUILDING CO RACTOR i cZv C.A
Size 6 g //��Sq. Ft. 1)6(1 Rooms C! 3 Stories �fp w
Height
(C)
Foundation 3 Class of Const. Occupancy Permit d
HEATING CONTRACTOR
Heat A/C p Vent Fuel /System Heat Loss
BTU'S
ELECTRIC CONTRACTOR C 1 f
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR c L\
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 r Permit Fee Paid //�!z�
l Park Dedication /��C��-
ISSUED BY 4 Date Q1 /4Y Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE L--� l
2 /G'Z.A./
AGENT /OWNER DATE
ADDRESS
TELEPHONE
6 S 4930 131 010 S
t
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations BUILDING PERMIT `J j ?C)
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. `.EST
nstr [IIVAC lec K Ibg Erosion Other:
Owne Name Mailing Address Telephone No. (include area code)
MLC/I, 2 a- 0 u e r, 1LC. �/y 2.7/ *26-7
Contractor's Name Mailing Address Telephone No. (include area code)
!i} Lot Area
.PT
T /SQ Sq. ft. 1/4, 114, Section T N, R E (or) W
Building Address Subdivision Name Lot No. Block No.
/3 9l W u/ 1 io OS"
Zoning District(s) W ing Permit No. ront I Rear Left Right
Setbacks �t t. 1i 6
.�.II.: tt �i �L/ ''v i i�i,}a�.`�_Y �i. C:`:::ii:::::<:•:•C:•:t::: ii ?j:'
6 6.A.A i:• i 4 ;•i 4 :iC• Y. k.. .d,. •ii: :::��i:::��. .iii li: {Pii? :��il�i:��i.'i1TY�:..�,..f�
ew Repair ingle Family Entrance Panel L' orced Air Furnace Fuel Nat. L. P. Oil Elec. Solid Solar
ID Alteration Raze El Two Family Size: /06 6 amp Radiant Baseboard or Panel Gas
Addition Move Garage Service: Heat Pump
Other (print): iderground Boiler Space Htg
"6 Overhead Central Air Conditioning Water Htg I
['Other
0 Other ❑Dwelling unit will have 3 kilowatt or
more installed electric space heating quip.
Site Constructed Concrete 9
1��k7 r %�E� >s Infiltration control option is: Full sealing
Manufactured Mn of joints. ❑Blower door test. 0 Exterior
P 9
•:2x .potek i Trea ry Wood Se r
air infiltration barrier.
//��jj�} S. S 074 Other pal
Unfinished Basement 672 Sq. ft. Munici i i S::
1 -Stor
❑septic s»' E! I:RT���� ,�..::���Il�i���
Story eU I.i Permit No
Living Area //be) Sq. ft- 0 2_Story Se sonal Envelope 6)�,Q BTU /HR
:!1 ?i AT Infiltration7ir7 BTU /HR
Garage 5d
they er rm n n €i!
(o sq. ft. L�J're a e t C•:::::::::
,j unicipal Utility 14 >zE:ST BU Othigg S c>r» ><E<<< i
C]111� ❑Other W'""
(Plus Basement Private On -Site Well 1 /71
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; und that the issuance of
the permit creates no legal liability, express or i Depart t or mu ".pal" and certifies that all the above informatio is accurate.
APPLICANT'S SIGNATURE 1 DATE SIGNED d?
IrS q1
APPROVAL CONDITIONS Th perm i s i -d pursuant to the following conditions. Failure to comply may result in suspension or
r �'evocation of this permit or other penalty.
le) �ii•r TEA
2) ,IL. 6 ii y-+ .4,1&-lest/ /442 ,7 /o ff'
Town Village t
County State of: ate o Municipality Number of Dwelling 9 Y Y p be o e lin
Y 9 Location:
J UR I S D ICT IO N -v
..........�:...u�po,t:� g :::.i ii:
Plan Review 4'b onstruction
Inspection fj HVAC Name _Q
Wis. Permit Seal ..he Electrical
Other Plumbing
umbing Date LAG `K
osion
Total l Cert. No. `472R
SBD -5823 (R. 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
3 0rADd
Revisal: 8/L
ZONING /LAND U S CO COMPLIANCE CHECKLIST
JOB LOCATION: �J/ 4 ZONING: I
PROPERTY OWNER /CONTRACTOR: R5e/a C0/0S77 00
CONSTRUCTION DATA: 4NEW CONSTRUCT10 ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
(House- l) Q W) (6ar4 c 5ns -4
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (fm t 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:
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 �j
REVIEWED BY: '�--E_ DATE:
i I I
n ...-4 li
Ill I r
,6��t. !,i Ilili,
V 1
j
(1 I i
(n i t
1 <Q, �.-I
c W 1 i ,.1,
t Iii l
d t� I 1 i i i 1
j IA I I it II'
I I !1 I' 11 I I
l 1 j '11111 i I
I a I 1
J 1 i i I i
c(LU::. I I I r� I
W pp W
I I i I I 1 1" 1 t 1" ..J I I Y
I I 1
i I I W � W
1 I III I 1 1 i 1!! i I( 4 I
.111 1 i.i •1 I!I i IA
I III j
1 1 i 1
I I
l
I
1 I i i t f t I 1
j i i i i I I j
j i i
I I i i 1 1 1 11 1 i I' 1
1 i 1: i
I i 1 I j t l 1 i i! 1
4•,,,I, L Lii, it I:u
cc
i 1 1
s II III' j• j
I liHI, 1 j;! d-
I I!I 1 !1 'I i; nt I
1 1
AA J
I V I. 1i If j f iu w
i 1 1 iQ311l I. 1 1 I 1 I
i I 1 11I∎1
1! I! 1 I l i 1 i j i i i i i I I I i i.
II '11 i 1: Ii 1 1 '11,
.11; It. i i
I; j j' i i1 1 11 1
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address
Owner's Name
Name of Subdivision 1;:t,A L &i
Lot /05 Bldg. Permit eg03
No. of Units
Fee Required 1
e
Fee Paid 4(4 7r00
Owner's signature 1 Date Z 2z 4
Inspector's signature J444 A MC II, Date 6 4 9
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
CATE 4/519g
NAME fUSC Ns o
N 4 ADDRESS
LOT /dS BLOCK WARD
SUBO I V 1,JET1_06g '2rn ZONE
STREET NO. /39/ w j4&4i elp Pay LOT DIMENSIONS
SIDEWALK EXISTING
YES 0 NO Q
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 21/7 ,19 Q4
BY e/J
FEE: $15.00
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade estaaiished before excavation has comme
00 930 3