HomeMy WebLinkAboutBuilding ., CITY OF OSHKOSH N2 23322
PERMIT - APPLICATION AND RECORD
TYPE: BLDG X HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING X .. / FLOOD PLAIN HEIGHT
ADDRESS /6 0/ ie PLAN NO. " 0 V3 05- 9ile-
OWNERiaS—
DESIGNER Jz€.,4) USE /NATURE OF WORK I f
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BUILDING CONTRACTOR !4. - , -
4 , Q Q
Size ✓icy Sq. Ft..2 � S3 #Rooms - � r , Stories 2 -'" .2 Height j
Foundation (�� Class of Const. P Occupancy Permit Ai
HEATING CONTRACTOR ALt t.4AMJ
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 P 1,
- BT WH Disp WSoft CBasin
- Lav Sh DW DF San. Sewer
_WC FDr SP Ur Storm Sewer
- Sink LTub Eject SS Water
Other
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FEES: Valuation / 10.00 Permit Fee Paid $ o252. 501/ Park Dedication $ /0 D 0 0
ISSUED BY , 419-7-f „ .! . �� s / /M /
� Date Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ,
//� �I �( AGENT/OWNER DATE
ADDRESS Q l eifl [ S / C'k�I� 4 4 ' Z3.�- ,c
TELEPHONE #
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: / 4 '-i' ,3., E 2 ,�4 zc 21 ONING:
PROPERTY OWNER /CONTRACTOR: A de,e,yre9,14, ,
CONSTRUCTION DATA: �IEW CONSTRUCTION ADDITION ALTERATI'N , PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
)110',6c) ji/ t 72 4//
COMPLIANCE CHECKLIST (Check only those applicable)
CO •LIES 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:__. ‘.8.4911-.ct_ (The Director of Community Development, or si , 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.
L/IAPPROVED DENIED
Plan Commission Action Required
Variance(s) Requi ed Adll
40
REVIEWED BY: ° i� % /�� DATE: 20%;
,/O * 3 0 9//C.-
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM
Labor & Human Relations BUILDING PERMIT APPLICATION NO 2- 7 Z Z'
Division of Safety & Buildings
Madison, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 Moo Instructions on back olpinkcopy) PARCEL 140.
: ERMIT REQUESTED ..:.: CONSTRUCTION ❑ HVAC ❑ ELEC PLUMBING «::; � ❑ U BING ❑ OTHER:
Owner's Name Mailing Address Telephone
Cont tor's Name Mailing Address Telephone 2-$4 `'...N, 'Fr
el,(4477f tell / 9 L e i ga, G 5190 / - 2 -3 t b
>_ ><Lot Area
.E. CT , ATION , ,
S ft. /a. /a, SECTION , T N, R E (or)W
Building Addr ss Subdivision N me Lot No Block No.
1/061/ � � %( ,' u.. ifal j
oning District(s) Zoning Permit No. Frank Rea Left Right
/E Setbacks ft. ft. ft. 2 a ft.
3.:::::: PRA.'::.::::.: > ::::.;....::::? . .. :: :.: 3 : Oc :::::: 8:: ° ELEC TIOCUI . :: VI.4VAC EQUIP ENT 12 ; SOURCE
'New ❑ Repair Single Family Entrance Panel $ Forced Air Furnace Fuel Ga
❑ Addition ❑ Move ❑ Garage Service: ❑ Heat Pump Space Htg• $ ❑ ❑ ❑ ❑ ❑
❑ Other 'Underground ❑ Boiler WaterHtg. ❑ ❑ ❑ ❑ ❑
Overhead KCentral Air Conditioning
❑ Other :4 c..::I>:$T ..::7 «:::FOUN AT$O + :
❑ Other * ❑ Dwelling unit will have 3 kilowatt or
more installed electric space heating equip.
Site constructed Concrete : ;: PLUMG ll i Infiltration control option is ['Full sealing
2. :: >::AREA:: fEk#<d ::: ::::: > <: «« Manufactured _ Sewer of joints. ❑ Blower door test. ❑ Exterior
T reated Wood Municipal air infiltration barrier.
❑ O ❑Septic
//�/ O S' IE, <:r :;::::.: :► :i.: At :.S: Ca iii i6 tt . . :
f
Unfinished Basement N. Sq. ft. h ... LOS'
Permit No.
0 23$3 1- Sto s» »> Envelope BTU /HR
Living Area S q . ft
2-Story 0 Seasonal 1 .A Infiltration BTU /HR
Garage 7 �, Sq. ft. Other Permanent &Municipal Utility 14 :< EST BUILDS COST
Other ❑ Private on -site Well
❑ Plus basement $ ' / 0 b 0 Q. v a
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 Departm rho nicipality; an that all the above information • accurate.
SIGNATURE OF APPLICANT DATE v 3( /4 - /
CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of th permit or other penalty.
P.- fi . 04 C3)U- 3 ai,.lr,..t-/ Aim 7 A Ott- ,� ' ( %
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Ammimimgroimiumr
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T OWN ' ❑ Muni i
❑VILLAGE CITY 0 c ali Nu mber of Mu nici ali Nu mber of Dwelling
P tY P tY
777 '
� .,; ❑ STATE IN EP ND Inspection Authority Location, if different
RI IV N a» /
t S' , ) PERII ' : W :U ORM: PERMIT` iiiii iY
Plan Review . . . $ 449 0 O Construction
HVAC / NAME
Inspection 7 5 il 4.1-1.4.4.1-7,L.--'
$ ❑Electrical l
Wis. Permit Seal. , $ 3 , C 0 ❑ Plumbing DATE TA 3 / g
Other $ 0 Other s- ry
TOTAL . • . $ ?0.00 CERT. NO.
SBD 5823 (R. 8/90) PTE — Issuing icjjQp , O 1 YELLOW — DILHR GREEN Inspector PINK —Owner /Agent
City of Oshkosh 1/1/85
PARKLAND DEDICATION FEE CCOLLECTION RECORD
Address J (o O / , :a
Owner's Name
Name of Subdivision
Lot # 3 Bldg. Permit # 2 3 32-71
No. of Units /
Fee Required / 90 •0 0
Fee Paid /00,0 o
Owner's signature Date
Inspector's signature /ye 4/1,4,eo..t- Date S //5i /9/
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
DATE /.3
9
NAME 9A1 ) Zt4 i4 1 . ADDRESS
LOT 3 Z BLOCK WARD
1dFtD
SUBDIV. /«i�) c.( ZONE
STREET NO. ./‘6/ t. i✓e,� /2/. ' LO
LOT DIMENSIONS
SIDEWALK EXISTING YES El NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE Si/ G , 19 C BY k 1*-J
FEE :.$.LO -Off"
lS:0Q
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DEPARTMENT OF PUBLIC WORKS . B
I, the undersigned, owner or agent of the above described prf*.agree to have the
grade estaaiished before excavation has commenced.
004331
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