HomeMy WebLinkAbout0044668-Building In
CITY OF OSHKOSH
N2 44668
PERMIT APPLICATION AND RECORD
TYPE: BLDG -HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS (:)L l U 1 N Ut AC S Root< TSAZ 6 PLAN NO. R± N 41g
OWNER SkJ31ER 1z 1E
DESIGNER
USE/NATURE OF WORK I T �C-U 1 ��'z-_ MIL-- t AITT 1�
BUILDING CONTRACTOR _4 S 0ZS-. -4411 •y.1
GS
Size k-R Sq. Ft. Rooms 1i1 `1 "t A1Z Stories a Height
Foundation COQ -�EN Class of Const. Occupancy Permit
HEATING CONTRACTOR nf\ c i v f\
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR N\GVZ\
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR \'1,
BT WH Disp WSoft CBasin
_Lay Sh DW DF San. Sewer
_WC FDr _SP Ur _Storm Sewer
Sink LTub Eject _SS _Water
Other
FEES: Valuat' Is �.O Permit Fee Paid fl Park Dedication 1 bt
ISSUED BY Q A Date l Q-
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR i
AGENT /OWNER DATE
ADDRESS
TELEPHONE#
ift--5,2/ `B-3- b`-kci \-\\q R J
Wisconsin Department of Industry, WISCONSIN UNIFORM BUILDING Application No.
Labor and Human Relations PERMIT APPLICATION Li
Safety and Buildings Division
P.O. Box 7969 (See instructions on back of pink copy) Parcel No.
Madison, WI 53707 The information you provide may be used by other government agency
Wisc nsin St t tes 1 101.73 pr. grams [Privacy Law, s. 15.04 (1) (m)].
k ::PERMIT :RE EST w: nstr 0 HVAC 0 Elec 0 Plbg Erosion 0 Other:
Owner's Name �J P T• .y Mailing Address Telephone No.
5ij0 Cfrxxo J P17D7 SH of ri i er C O I oS g t/ y ,0 7�i'r�, /pi)/ fr/ Lep, xi 9 (�/y 7,1/
Contractor's Name: Con Elec HVAC Plbg iUCert Mailing Address Telephone No.
D) J� 6/ e/
Contractor's Name:,❑ Con Etec VAC Plbg ic/Cert Mailing Address Telephone No.
/veil fin;
Contractor's Npme: Con Elec HVAC Plbg ic/Cert Mailing Address Telephone No
.0
.c b OCk.
Contractor's Nam on Elec HVAC Plbg ic/Cert Mailing Address Telephone No.
.r ....ko w ?I!: lT i Lot Area
;I Sq. ft. 1/4, 1/4, Section T N, R E (or) W
Building Ad A
d ess "y S u bddiivi is sion Name L Lot No. Block No.
in
Zoning District(s) Zoning Permit No. Front Rear Left Right
Setbacks 24 ft. 7 ft. le ft. l ,rs ft.
K.. .FEY. p .is:iii:i. }iii v:
i v: >::Yi ii ::i: :ii y .iii:
CrJt�. �Y... ..>�....w~(.rMCI��.: K V., �C.: f: ll�l�l»
>:I«N�R.>��': SSG. i€ 1��
u ew Repair n Ingle Family Entrance Panel 'A orced Air Furnace L. P Oil Elec. Solid Solar
Alteration 121 Raze Two Family Size: ISO amp Radiant Baseboard or Panel Fue Gas
❑Addition ❑Move Garage Service' 12 Heat Pump Space Htg
❑Other (print): PG nderground filer
❑Other Overhead Central Air Conditioning Water Htg 2(
Other Dwelling unit will have 3 kilowatt or
t$T.T#�E..T... El more installed electric space heating equip.
Si le Constructed liKoncrete
»U0 ,NO<<`<<> Infiltration
control option is: ❑Full sealing
of joints. ❑Blower door test. ❑Exterior
z INvotvE anufactured Masonry ❑T Sewe reated Wood air infiltration i
::5 :<ST.. AiFE >z Oth r unicipal
barr er.
Unfinished Basement( 3iaq. ft e ;:.::.;:.:.:.;:.;i;:;.::::.:;:: >ii;i;;- .fir
>:'::i W :Ili.: ':.1.,.`:. b 0
Septic >s
Permit No.
Living Area P Sq. ft. ory Seasonal Envelope 1 BTU /HR
;WAT 3 Infiltration S BTU /HR
S ft. Other ::1 3 oZ
Garage q
unici al Utility L�
P
❑Other tSin IWIWING.!5T:•;•;.;.
Plus Basement Private On -Site Well COO
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 muu cipalit and certifies that al the above information is accurate.
S4 fi r..,. i P ,noP�7 eC Pier h- se /J
D( APPLICANT'S SIGNATURE Imo., /4± y'Q DATE SIGNED orp72//7,5
APPROVAL CONDITIONS This per t is i ed pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalty.
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6/ rvrZN/ s�+( 7euss rdrq l '-S c Sl ,,(T W7Ar>T //r S o /L),
T
own
Village e
t
County State of:
Municipality Number 9 Y u ber of Dwelling Location:
Y P Y 9 n: 0
URISDLCTIO I C? R 6 6
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.::.::.i'.:i.:.:;::i::i iii:<:.::. ?:.ii>::.:.iiii::: i:a::a:: '{r ...SCIM '.i:.: i::.;::.;:: i: ii ?:/':::::::ii: i;;: :ss:; i ::.i:.i>:::::i:.i:.:<. iii:<: :::iiiiii:;:::: ::<::i4 ii::iii:�i:
..n i }i::J:� i:+: i
Plan Review 4- 10 1 Construction
Inspection "j H /AC Name I i
Wis. Permit Seal Electrical �S �S
/�0
Other Plumbing Date
Erosion
Total 7�-� Cert. No. L k I CD
SBD -5823 (R. 06/94) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
4 //4,9.3
39 .c7(t►-u yam' cxu
(1O/ULf&)bY< ZONING /LAN USE COMPLIANCE CHECKLIST JOB LOCATION: 31 1 21 UC ZONING
PROPERTY OWNER/CONTRACTOR:S71(;a)ya CFECe
CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
(&)6 6 V a(A L f/ ArrAc
1400 se 19
COMPLIANCE CHECKLIST
DEFICIENT COMMENTS
Use
Lot Width
Lot Area
Lot Area Per Family
Floodplain
Front Yard
Front Yard Side Street
Rear Yard
Side Yards
Building Area
Parking Standards
Off Street Loading Standards
Vision Clearance
Transitional Yard Standards
Landscape Standards
Height
Conditions of Approval
Compliance with P.C. or
BZA Conditions of Approval' GCi 61-/
Signage Standards
Drainage Plan
REVIEW AUTHORITY
As per Section 30 -5 Enforcement of the City Zoning Ordinance, the Director of Community Development, o
designee, must approval 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.
1✓� APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: DATE: Arfiri—
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CATE L IP// 95
NAME cAw (/O' CIZEQ< pre® PG 1 7 6 3 ADDRESS
LOT "39 BLOCK BARD
SUBDIV. i4v C ZONE
STREET NO.
Wt 45B2s:3 K LOT DIMENSIONS
SIDEWALK EXISTING YES El NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 4 cV ,I9 lS BY t. N
FE!: $15.00
DEPARTMENT OF PUBLIC 'WCRKS
1, the undersigned, owner or agent of the above described property agree ro have the
grace established before excavation has commenced.
4 1 1 1
City Of Oshkosh 1/1/85
PA RKLAND DEDICATION FEE COLLECTION RECORD
Address VH \k)(1.3N f 1 K
Owner's Name A.,1 eRICSQ. 1
Name of Subdivision uoq
Lot Bldg. Permit y L i C
No. of Units
Fee Required \,C)D
Fee Paid L OD
Awner s si natur '�i C- i 6 S Date
Inspector's signature 4 Q S Date L I' OS ViS
Parks Subdivision
Improvement
r;ccts. Rec.: 352