HomeMy WebLinkAbout0025816-Building CITY OF OSHKOSH N°_ 25816
PERMIT APPLICATION AND RECORD
TYPE: BLDG g HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS d/0 ti.1 G 'L 4-- PLAN NO.T /n /0//it-
OWNER /2i4.. 67-a7
DESIGNER Z
USE /NATURE OF WORK »21.() ,I A 1 ,i/ -/P
BUILDING CONTRACTOR e)6/171- 1l1
Size Sq. Ft. /9F. r Fom� 7 Stories �.u-� Height A L B
Foundation (�.�L Class of Const. Occupancy Permit
HEATING CONTRACTOR fic1. -11
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR L
Electric Serv. New Change Te Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR r) f"
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 .5449 00 4 0 D Permit Fee Paid /5 0
11.1.i11.11-e..a--' Park Dedication D O O 0
ISSUED BY O 4 C Fin I G Date a /OP.
In the performance of this work 1 agree to perform all work pursuant to rules governing the described construction.
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p V SIGNATURE (a
AGENT /OWNER DATE
ADDRESS
TELEPHONE
=3 lei /D/,'C-
State
Department o finnd Industry, WISCONSIN UNIFORM
Department f Id
Labor Human Relations
Division n of Safety 8 Buildings BUILDING PERMIT APPLICATION NO.
Box 79
Madison, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
PER MIT REQUES
L�J CONSTRUCTION HVAC El ELEC Ell PLUMBING OTHER:
Owner's Name Mailing Address Telephone
Contr Name Mailing Address Telephone
A Abi Pm 8748 w iitrz4 1 c 3'-' 2 3
Lot Area
PR E T ODA
Sq. ft. '/a SECTION T N, R E (or)W
Building Address Subdivision Name Lot No. Block No.
Zoning District(s) Zoning Permit No. Front Rear Left Right
Setbacks ii
G ft. .7 ft. ft. ft.
C T >E E L ECTRICAL iC PIP E :!:ENERGY SOURCE
ew Repair Single Family Entrance Panel orced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
❑Alteration Raze Two family Size: _ILA! amp Radiant Baseboard or Panel Gas El El
Addition Move Garage rvice: Heat Pump Space Htg.
Other nderground Boiler Water Htg
Overhead Central Air Conditioning
Dwelling unit will have 3 kilowatt or
g
Other Other e Ilin more installed electric space heating equip.
ite constructed
IL* 1f 0
f.IJMGl�li51 Infiltration control option is: ❑Full sealing
2 ARE I D: Manufactured Masonry Selor of joints. Blower door test. Exterior
Treated Wood Municipal air infiltration barrier.
Other
Septic P i3.:#1►�':Lt$ falcul,3€t�ct
Unfinished Basemen q ft.
1?
Permit No.
A BTU /HR
Envelope 3 81K
Living Area 99(� S ft
9 q
n 1�'� .A'I'ER; Infiltration
Stor aso al BTU /HR
�4 Other Permanent
Garage �J 9 6, Sq. ft. Other Municipal Utility "I4.::�F�: ILA G0$T
El Private on -site Well
Plus basement CO, Q 0 0
The applicant agrees to comply with all applicable codes, statutes 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 Muni lity; nd certifies that all the above information
n is accurate.
SIGNATURE OF APPLICANT ti
DATE (v 4-1
CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalty.
(4 e.f/a-kr(-d-rt 1 1 0- 4 ed
ir k r
0 TOWN VILLAGE ITY COUNTY Municipality Number of Municipality Number of Dwelling
C COU P Y P tY
❑STATE IND P ND EtYT Inspection Authority Location, if different
J URISDICTION
PERMI IfIS.:Ut RMPERMW
00 k i Construction D
Plan Review 7"//0�,, b HVAC 51rlit93/& C/JJ
Inspection ❑El NAME Electrical
Wis. Permit Seal, C•0 O ❑Plumbing DATE 9/
Other Other
TOTAL 70 0 0
CERT. NO. S 0
SBD 5823 (R. 8/91ir WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
ZONING:
JOB LOCATION: 4
PROPERTY OWNER /CONTRACTOR: _1
CONSTRUCTION DATA: 6EW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, p ool, sign, deck, etc.)
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT
DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frart 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:
Communit Development, o design
The Director of Y must approve all plans, except
o he n g e
the
following: (1) Alterations or interior work when si�enuse f w th use is
in use is proposed. (2) Maintenance items, e.g. g• windows
conforming and when no change is proposed.
Instances where work complies with the above 0irector of Commny Development, Building Inspector without referral
PROVED DENIED
Plan Commission Action Required
Variance(s) Requir
O
REVIEWED BY: DATE:
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DATE /0 /q
NAME 7 4,a a- ADDRESS
LOT '5"-Y BLOCK WARD
SUBOIV. D-}C ed ZONE
STREET NO _LOT DIMENSIONS
SIDEWALK EXISTING YES 0 NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE ®n r /lo 9 6 8Y
FEE: 410.00
DEPARTMENT OF PUBLIC 'WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
Of 4
448
City of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address .21/0 /,J L
Owner's Name K-
Name of Subdivision Al
Lot 5 Bldg. Permit
No. of Units
Fee Required ZOO p
Fee Paid (o0,0-0
Owner's signature ,2 2 Date
Inspector's signature e.././s rt Date /0/
Parks Subdivision
Improvement
Accts. Rec.: 362 -041