HomeMy WebLinkAboutBuilding /`', CITY OF OSHKOSH N° 20387
- PERMIT APPLICATION AND RECORD
TYPE: BLDG 4 HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING / FLOOD PLAIN HEIGHT 2 4
ADDRESS /4 /9 4.4)K/t ) 94 : 411 l PLAN NO. PP/92 -990/z
OWNER Ai-4d B `
DESIGNER �^ �}
USE /NATURE OF WORK / ' J s ) [. 2 (1-61 �
BUILDING CONTRACTOR 'Oaf /i /�
Y-fa
Size Pe Sq. Ft. 2Z 7• - # ooms 'f BEb # Stories ?/ Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR "e
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
I
ELECTRIC CONTRACTOR 1 4 gel.e,
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: Valuatio $ 4/2 0 0 Permit Fee Paid $ /3 S• 0 v Park Dedication $
ISSUED BY 7S. f /,w4c� Date /%Final /O.P. "03 - ( 1'1
In the performance of is work I agree perform all work pursuant to rules governing the described construction.
SIGNATURE �
-f �G� pC ..5 L /%® G�
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
1 �/
JOB LOCATION:
� //� /� .()�.G/4(4 i-e`29 �?�� ZONING: '7
PROPERTY OWNER /CONTRACTOR:
CONSTRUCTION DATA: v4EW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
)4/,(A) f ,e- 2�x c��C "
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frort yard)
Rear Yard
Side Yard (R)
Side Yard (L)
• Parking Spaces
Building Area
Lot Area Per Family
Corner Lot
Landscaping
1
Transitional Yard
Off- Street Loading
Vision Clearance
Height
REVIEW AUTHORITY: /.
0 ITY: olati*,
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: 0/ DATE: 9� /n
State of Wisconsin
Department otIndustry, WISCONSIN UNIFORM 9203 .17
LabsHuman Relations
Divisi on n of Safety 8 Buildings BUILDING PERMIT APPLICATION N .
Madison, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 See Instructions on back of pink copy) PARCEL NO.
.. ER.I T REQUESTED . .:::: „
ST RUCTURE ❑ HVAC ELEC PLUMBING
er's Name Mailing Address Telephone
Aed el 416-.44. ( � ❑ C I
Ow
....... ........... .... ... ............... . ........ ..
r
Co tractor's if< Name �� Mailing Address Telephone
. . ...�. 1 oo Ic' u/�!�// Z,31
ECT L110N
%, %, SECTION , T N,, R E (or) W
Building Address //�� Subdivision Name Lot No. + Block No.
/419 , ,?74, / /ZA". /l� j
"` v`7
Zoning Distr t Lot Area Front Rear Left Right
_ 1
sq ft. Setbacks J ft 7 L
ft 7 r S r-
ft. 7• S ft.
a.:::.... '.::: � :; > 7YPE.; ; ; ; ;; <. : .; ; ; ; ; ; .�.:
; ELF: �AL::< ::<: ::�.: »#I�t'�4C::�[PEI��' ; :: ; : :.;�:�.::.:ENERG1F:30Ui :.:
( New ❑ Addition ❑ Raze m, Single Family Entrange Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. Solidsolar
*
❑ Alteration ❑ Repair ❑ Move Two family Size: D amp 11 Radiant Baseboard or Panel Gas
❑ Other Se ice: ❑ Heat Pump SPace Ht9• $1 ❑ ❑ ❑ ❑ ❑
❑Other Underground ❑ Boiler
Water Htg. riff ❑ ❑ ❑ ❑ ❑
Overhead ..... :..: :. X Central Air Conditioning
h r * ❑ Dwelling unit will have 3 kilowatt or 0 . -, ,, more installed electric space heating equip.
Concrete
I nfiltration control option is: Fu ll sealing
Sit constructed Eft <<m':< >> > >.. P ❑
Attached ❑Detached .
> ;;;: Manufactured 6 Masonry wer of joints. ❑ Blower door test. ❑Exterior
»:AREA. » »> << > »» air infiltration barrier.
...................:.. ❑Tr eated . . . .
Wood Municipal
❑ Other Septic '
Basements /QVd Sq. ft �::::�TI�: :::: >< .:: .. . .. .... :... . .. �:� «:?:�'�I�S: CSICk>�IBiiii#«< >>
Permit No. ��
2 .9---Sq. ❑ 1 -Story 8 :<_: < ?< > Envelope a BTU /HR
Living Area ft.
2-Story
Seasonal 't :::...: < ' <<<<«< > >< > >>
rY ❑ a ..... �1t...:._.:.. ... ...:.::::.:... Infiltration /7 /27 BTU /HR
`JZY Other El Permanent Garage Sq. ft. t Municipal Utility 1 4. � $�„CO$T`<<
❑ Other p
Private on -site Well
- $ / ON. DD
The applicant agrees to comply with the Wisconsin Uniform Dwelling • . d- and other Municipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no le. al Iii lity, express o mplied, on the Department or Municipality; and certifies that all the above information is
accurate. irt.
SIGNATURE OF APPLICANT .. --ei - DATE
CONDITIONS OF APPROVAL This permit ist issue. /:ursuant to the following conditions. Failure to comply may result in suspension or
revoca o f thi pe mit or other penalty.
M i4 rt . 3 , 08' (1 ) @) /To �fo,r hT� k2ur.T mac, K. w, A da/
a/ • 0 3 (2) e ..., /A.14 al!eZ,AL , ,dfavrt i .�Ci-oc.
T Municipality ❑ OWN c all N
❑VILLAGE (CITY 0 p ty umber of Municipality Number of Dwelling
❑ STATE ❑ INDEPENDENT Inspection Authority Location, if different
'J RISS 'f< // //
,16r
Plan Review . . . $ V° Construction 141
HVAC NAME Inspection . . . . $ ❑ Electrical Y4 9
Wis. PermitSeal(s) $ 30 ❑ Plumbing DATE q / ./2' > 9 i a
Other $ ❑ Other
TOTAL . • • $ -id CERT. NO. r2 S rO
SBD 5823 (R. 4/89) / L O0 0 o WHITE — Issuing Jurisdiction YELLOW — DILHR GREEN —Inspector PINK—Owner/Agent
"
r---1.......1
Fred P. Litjens
BUILDER
4537 HONEYSUCKLE - OSHKOSH, WISCONSIN 54901 - PHONE 231-4504
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DATE � / � o
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NAME ,, _ ��` ✓ / ADDRESS
LOT el,-c; BLOCK r,
!ti &D
S UBD I V . A., iz ,I77 / ZONE
S TREET NO. /G / 9 /` I've- - 74/ / f LO D IMENSIONS
SIDEWALK EXISTING YES LIJ NO EF
BUILDING GRADE ELEVATIONS STAKES SET AT SITE Aolot; / 7, 94 BY
FEE:
$10.00 /2
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described pro• -r y agree to have the
grade established before excavation has commenced
i
004 273
�/ 6
/ •
City of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /47, Are,4 ( i 7 d //
Owner's Name dA.A.1 P 0
Name of Subdivision /C. - riµ A,
Lot # a9 Bldg. Permit # 49 3 7
No. of Units
Fee Required l"
Fee Paid • I
Owner's signature .. Date
Inspector's signature 1 1 Date 9//3/jr'D
Parks Subdivision
Improvement
Accts. Rec.: 362 -041