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HomeMy WebLinkAbout0042434-Building //a CITY OF OSHKOSH N°- 42434 PERMIT - APPLICATION AND RECORD TYPE: BLDG TG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING / FLOOD PLAIN HEIGHT ADDRESS .7/4/3 t` / -Oei -h PLAN NP "17 / — ' OWNER lz �S e-" KS ' I v-t 1 �4-/,, DESIGNER ,,,, 99 /� USE /NATURE OF WORK /fJ �\ + P- r°"' BUILDING CONTRACTOR 0 tA3 /•R r �r Siz� tiw�� Sq. Ft � g �� ooms t' L 6(' # Stories / Height /62 Foundation /� Q J° Class of Const. Occupancy Permit HEATING CONTRACTOR C 1 — °c.c.Je_ f Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR e- _T Electric Serv. New ❑ Change ❑ TWp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR - h AEI`— e ` C 6=' - 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 J 0S/O.PJ i Per Fee Paid $ A V Park Dedication $ /00 ISSUED BY / 0 "4i� ..LA, Date i Final /O.P. / In the performance of this work I agree to perform all work pursuant to rules governing the described construction. 7 SIGNATURE 1 (4 AGENT /OWNER DATE ADDRESS TELEPHONE # 5j 1 Wisconsin Department of Industry, WISCONSIN UNIFORM BUILDING Application No. Labor and Human Relations PERMIT APPLICATION Safety annd d 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 WiSCOnsintatytes 101.63. 101.73 programs (Privacy Law, s. 15.04 (1) (m)1. :;':;:;PERMI REQUESTED Constr L. HVAC ❑ Elec ❑ PIbg 0 Erosion ❑ Other: Ow is Name Mailing Address Telephone No kill-fill G a7 L 0Ill n / ( ) 23/8263 Contractor's Name: ❑ Con � . [ lec ❑ HVAC ❑ Plbg LiUCert # Mailing Address Telephone No. l Co tractor's ' • : • Con ❑ Elec 'NH! 4VVAC ❑ Plbg Lic/Cert # Mailing Address Telephone No DANAI-e/u 1 , - , ( ) Corura or's Name: • to ❑ Elec ❑ HVAC Ibg LiUCert # Mailing Address Telephone No. Contractor's Name ❑ Con ❑ Elec ❑ HVAC ❑ Plbg Lic /Cert # Mailing Address Telephone No. ( ) PROTECT LOCATION Lot Area Sq. ft. 1/4, 1/4, Section , T N, R E (or) W Building Ad ress Subdivision Name Lot No. Block No. • 3KA 1O �! ' � �,� Zoning District(s) Zoning Permit No. Front ft ht Ri : » ..:.. ;: >::: :: ;.: >; :; : ::.::::.:.;:., ;..:....•.:.:...::.;... ft. ( Rear Le 50 ft. Z3 ft. �S ft. :: < � g ...OINTA::::::::::• :::• :. :.;..........:.. %: ::. .. CUPAN V ii: v y y] �yi�`y�.yi: a :., {y :n j yy++yy m�E� `} y ,y t . .... .. ... .:. . .::: ..:: .. .... ... ��... I�LEl►: 1 . 1 G...... ��.. ���11[. �. �I!: �: I' IIiMv:: F j :' I�: I�M��:: Y ��. �i:?: :> l ew ❑ Repair KSingle Family Entrance Panel • fErtOrced Air Furnace Nat L. P. Oil Elec Solid Solar ❑ Altefation ❑ Raze ❑ Two Family Size: 100 amp ❑ Radiant Baseboard or Panel Fuel Gas • * ❑ Addition ❑ Move ❑ Garage Seryice: ❑ Heat Pump p Space Htg ❑ ❑ El ID ❑ Other (print): nderground ❑ Boiler ❑ Other ❑ Overhead ❑ Central Air Conditioning Water Htg ❑ ❑ ❑ ❑ ❑ ❑ ❑Other * ❑ Dwelling unit will have 3 kilowatt or :: . T ' ' 7 N 114) '! ... more installed electric space heating equip. e Constructed oncrete S it p g g ;;. ❑Manufactured ❑ Masonry • � •� �� � � : : : Infiltration control option is: ❑Full sealing Sew r of joints. ❑ Blower door test. ❑ Exterior .ti meo "` " '` ' ` ❑ Treated Wood air infiltration barrier. an 5 >, iT s :> niiiii' anicipal flu Unfinished Basement �� -pp Sq ft- ❑ Other :::::::.::;:::;. se ti : :i'i : 1%: : : IIM O.-• . : _. i:::. : > : d> er it : 4.Si i : : : :i Eiii:: Perm No. Living Area ( D n Sq- ft. i Envelope .��Q��" BTU /HR ❑ S asonal Infiltration P42. 3.> BTU/HR Garage 5L-0 S ft. Other [rmanent :.... g q unici aI Utility L p ❑O ;...:...: �;. tI����>� • :s: »:3a >> 0 Plus Basement - , ❑ Private On -Site Well $ .L.J a l"1/1 The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; Snderstands that the issuance of the permit creates no legal liability, express or implied, f ee partment or municipality; and certifies that all the above information is accurate. APPLICANT'S Unfinished 7rosA., DATE SIGNED /V rAel q APPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. . i�uf 'r✓ �w-.cs ?mil' k' /ilr. e- r1'1-c f CA. f ,,-- 'eAo a. l r.t..'r - v-,7 / Pe 4...s crc—N S 1-ii., ... 4-- 0.4, A 1Fi - e_lir c. c fr. p V.i* - t ( lc i Lac —Co ay * s) Sh lt e4P. Twn 0 Vi lla ❑ e it Count ❑ Sta of: Municipality ❑ unici alit Number of D Y County ❑ be o Dwelling P Y 9 Location: J 1RISDIC�'I N : c kk -h `7 6 - a Co ....:.... . ..... : ................ :.:::.1 .. .� .::.�:: :. .. .. .. :.; : ::::ii�i i:: `::i $ : i i:! �iy � yM.i�= ............:.:.... ........................... :...... .:: ::. ::: : :.............: . : : : :: .. . ........ .... M::: ... ... ......:...... g:1 : : : ............:.... . ... RIN: I/f MM :: IIL.ti.i:^ii: iiii:::::.: �: :v: :v iil:.ii:• • :Lv iL• Plan Review $ �� construction .......... ..: .: �iy :::::::::::.: :::: iiiii: •:::::::::. Yi���i.. . : �: �'`.� ... ....:.i::.;:•.�::::: .::::::: .:::::: ::.{i. ii} } i�.i: ....�:::::::::i:n::::: iiiiii:�iiiii:::::::::::::: :.:: :: :::::::: :.:::: is ..................... •.............• ............ : �.� :• : :::::::::. �• i:i:: ii��: �i:•i ?iiiii:t ?::::i:iiii::iii iii'il::ia: ? >:iiiii i i ;iii:: %i:i::: is ^ iiiii /� ��\ �� Inspection $ VAC Name 1 L Wis. Permit Seal $ "TO ❑ Electrical Y (197K.\ Other $ ❑ Plumbing Date ❑Erosion Total { $ �� ❑ / �J Cert. No. SBD -5823 (R. 06/94) WHITE - Issuing Jurisdiction YELLOW - DILHR GREEN - Inspector PINK - Owner /Agent Ls: 7c IS — k) ( �FN C ZONING /LAND USE COMPLIANCE CHECKLIST o JOB LOCATION: S1 ;11kiel ` \i Q ZONING /� PROPERTY ONER/CONTRACTOR: c W v C-`R CONSTRUCTION DATA: New Construction Addition Alteratior TY E OF CONS UC \Q. TION: (i.e. fence, pool, parking lot, sign, etc.) _/ A ` ^ M `I (' �LQ CL._ r � �` '‘QS z i — .L_ . --. COMPLIANCE CHECKLIST &\Q— ?- 5 r 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 ✓ /��/ / a) Signage Standards Cc 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. % APPROVED DENIED Plan Commission Action Required Variance(s) Red ired REVIEWED BY: 66 ' 44■411K/ ' DATE: //. / tY c /0' 1 2. 4 0 c0 N f ( /IQ 1 0 ZA 6ravci Driue A.- I L2 4,1:i * /8 at friji A titi >(:) ,a r (Pq CATE 4 D\ a 19.4 NAME US ADDRESS LOT IQ BLOCK WARD SUED I V . evC.IL ZONE STREET NO. ?)2 ie.AA V LOT DIMENSIONS SIDEWALK EXISTING YES 0 NO Er BUILDING GRADE ELEVATIONS STAKES SET AT SITE © , .3/ ,I9 9 -' BY.Z24L FEE: $15.00 , l/I, ,,- /,(;,(yr_Aa_ DEPARTMENT OF PUBLIC WCRKS I, the undersigned, owner or agent of the above described property agree TO have the grace established before excavation has commenced. 17-5-17........ /09,4,. City Of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address 3 t e f l -Cr e!d/ Owner's Name c 4 Name of Subdivision VIll G �h ld . � Lot # / Permit # 9 No. of Units / Fee Required /00 Fee Paid /cop Owner's signature yam. , _ Date /( y 4F Inspector's signature 1 , 1.11r% Date 3/ Parks Subdivision improvement Accts. Rec.: r1