HomeMy WebLinkAbout0019120-Building CITY OF OSHKOSH N°_ 19120
L' PERMIT - APPLICATION AND RECORD
TYPE: BLDG .r HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING 1 f FLOOD PLAIN HEIGHT
ADDRESS /3/'O /[J a. jrrm �u.� PLAN NO. 7 / 91 PO
OWNER 'K.. , � r< _ / W4 •
DESIGNER AA
USE /NATURE OF WORK /[J € ' S k
BUILDING CONTRACTOR �XP G`c9Cl.�
, ,
Size Sq. Ft 7 # Rooms ' T' # Stories n i..ac , Height e --
Foundation > Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
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 $ S 0 P -rmit Fe: Paid $ Z • Park Dedication $
ISSUED BY 'A i
Date Final /O. P. /i •'
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
P Pi G e
State of Wisconsin
Department ot Industry, WISCONSIN UNIFORM
Labor Human Relations
Division n of Safety 8 Buildings BUILDING PERMIT APPLICATION NO.
s a o, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 See Inns on back of pink copy) PARCEL NO.
ER� E QU `E STRUCTURE ❑ HVAC ❑ ELEC ❑ PLUMBING
Owner's Name Mailing Address Telephone
/(9; �1C /4
Contractor's Name P G` �•s.r Mailing Address Telephone
1/4, '/4, SECTION , T N, R E (or)W
Building Address Subdivision Name Lot No. Block No.
/ ; tv Aj cc O `ue- i z f
Zoning District LokArea Front Rear... Left 2 Rig
( . 7 0 0 Sq. ft. Setbacks �S ft. ft. 7 ft. �( ft.
<:. � <::; >::: > » >:: >:::<«««:::::>:: >: ;:::::<::< ::<::<::<:: >::::<::::::. «:::.:. AL .........# f�`, �C: IQUIPME+ I1':::: .;:.;:.:::<:<<:.:.:i:V:EN R...::<.
fle ❑ Addition ❑ Raze ailgingle Family Entrant Panel orced Air Furnace Fuel Nat. L.P. Oil Elec. Solid Solar
*
❑Alteration ❑ Repair ❑ Move ❑ Two family Size: 6 -r, amp ❑ Radiant Baseboard or Panel Ga s
❑ Other Servi e: ❑ Heat Pump Ht9• El ❑ ❑ ❑ ❑ ❑
❑ Other . Ji derground ❑ Boiler Water Htg. E. ❑ ❑ ❑ ❑ ❑
❑ Overhead ❑ Central Air Conditioning w llin ni will have kilowatt or
❑ Other ❑ D a g `u t a e 3 ki
'� � �` F�II�A�� * more installed blectric space heating
Wached ❑Detached ite constructs
onCrete P' ;U : Infiltration control option is: 0 Full sealing
❑ Manufactured Masonry r of joints. ❑ Blower door test. ❑ Exterior
2 : AREA ::: »:: » » >: >:: : : :i : »: >:: >: > :': Treated Wood air infiltration barrier.
...... .............. .....................
❑ 'C1`Munici
— . ... > ::> .. ❑
0 > : :> ::.:.:...:.:....:.:... ..:..:::: ....:...::..... ::::
Basements - 7'� 1 S : + ::: IE ::: >:: : «:: >:# > `:;: {Gsl lst ): < <:«:<
Sq. ft. : Permit No.
❑ 1- Story > :::I :: >> ..... -::: <: ><: Envelope -S O BTU /HR
Living Area '- Sq. ft. « «« « «< ::
< < ::
2 Story ❑ Seasonal WAVER : ;:; ; ;: ; ;!ii:ig : ::: : :: Infiltration 0 BTU /HR
they ermanent
Garage S . ft. Municipal Utility I*E7F:$IL4IST
9 q � U Other ❑ Private on-site Well 0 :::.:.. ............................... $
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Municipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legal liability, express r implied, on the Department or Municipality; and certifies that all the above information is
accurate. ��
SIGNATURE OF APPLICANT `��""'� DATE
CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspensor
revocation of this permit or other penalty.
ems\ (J {A " ---; + 6 ee.v.../(....._
P� tr-te MS c.c.s t v, S -...rte, (7 l� p )woo -u l �4... `ecvr •r -- 4c/e( I r-enoa —
tixeL kte eN lea. - m�tv ' /, `' ( // i1X X fi /�
c y 57 (( All: In sr: . `' G L. ci e <---
i Municipality TOWN a Number f
[ ❑ O ❑VILLAGE ITY COUNTY b o Municipality Number of Dwellin
❑ COU TY P tY P tY 9
❑ STATE ❑ INDE E In ection Authority Location, if different
UR SO N ::<:: /
::PFIoI :: :'
................ ...............................
Plan Review . . . $ •Sf onstruction ( 40 ' -,
it
Inspection $ HVAC NAME A'I ` s
❑ Electrical -
Wis. PermitSeal(s) $ ❑Plumbing Plumbing DATE .iAP
Other $ ❑ Other
TOTAL . $ �� ��a7 S CERT. NO. A NI
SBD 5823 (R. 4/89) WHITE — Issuing Jurisdiction YELLOW — DILHR GREEN — Inspector PINK — Owner/Agent
DATE 4/7217
ADDRESS
LOT 24' BLOCK WARD
SUBDIV. ZONE
STREET NO. /3/9 ,q apLe . LOT DIMENSIONS
SIDEWALK EXISTING YES El NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE ,19 BY
FEE: $ 15.00
DEPARTMENT OF PUBLIC WORKS /4E_ ,s•
1, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
04475
Revised: 8/89
ZONING /LANG USE COMPLIANCE CHECKLIST
JOB LOCATION: /3/0 . ZONING: da " I
PROPERTY OWNER /CONTRACTOR: ,41L E
CONSTRUCTION DATA: LNEW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, ig n, deck, etc.)
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (front 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.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: DATE: Arc)
EXISTIMG FE NCE
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11 I -S
m I S ITE 11
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ST U _ TO SITE 11
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13.M.SEE SITEII
(i) W
NATIONAI- AVE,
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L UT 2 ci s ► rE q . �10
1310 NATIQMAL- AVE Mir
NOTE :I)1 -15E. SITE 9 /lo /If FDR UFFICE STLRAGF_
ANI, STAGGING AREA.
2)REMoVE EXIsrIMG GRAVE FRoM SITE'S q /IOJII.