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HomeMy WebLinkAbout0048009-Building 110 CITY OF OSHKOSH N° 48009 PERMIT — APPLICATION AND RECORD TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING 11 t FLOOD PLAIN 471.21L. HEIGHT ADDRESS ISOS We ,i. ✓c•-, C■ re.lt, PLAN NO. A l /< OWNER -4- I ) _ ¢- a a.__ DESIGNER' -'-" \ � USE /NATURE OF WORK 'v 51' BUILDING CONTRACTOR -- r. , -4-VD pC -Je-t iV v..e. , Size %( t S . Ft. �� Rooms 1 n f M ' q 10 b1' -' S # Stories 1 Height Foundation 4 Class of Const. L� Occupancy Permit rl V tL4. HEATING CONTRACTOR i ko■-5 w1U55X-■ Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR Ww►►n Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR ■ wL t %4( \1/4.1 vvti h 1 w - BT _ WH _ Disp J _ WSoft —. CBasin - Lav _ Sh _ DW _ DF — San. Sewer _WC _ FDr _SP _Ur _Storm Sewer - Sink LTub Eject — SS — Water Other 6 c i FEES: Valuation r� $ , r� Dn �Q Permit Fee Paid $ a • � � �� Park Dedication $ 1 D�caD ISSUED BY l/i Date t 0 Final /O.P. In the performance is work I agree perform all work pursuant to rules governing the described construction. SIGNATURE � ` 7"1"-c?----- `- / � L ��r AGENT /OWNER v TE ADDRESS S ` / �` - � s-f , O� " ` &/,/ / & ( ,Z3 f A ‘ y / / TELEPHONE # • • ZONING /LAND USE COMPLIANCE CHECKLIST JOB LOCATION: IS W (LOA/ 4, ZONING RI PROPERTY OWNER/CONTRACTOR: ) i ;Jc, I „e meg - CONSTRUCTION DATA: "7C New Construction Addition Alteration • . TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) S"r COMPLIANCE CHECKLIST DEFICIENT COMMENTS Use Lot Width Lot Area Lot Area Per Family Floodplain Front Yard Yo z )( 0 Front Yard Side Street Rear Yard \r>e-- / 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 Signage Standards Drainage Plan \l7 PA (k REVIEW AUTHORITY As per Section 30 -5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or 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. y APPROVED DENIED Plan Commission Action Required Variance(s) Required REVIEWED BY: Lii2 DATE:/',— -- Wisconsin Department of Industry, WISCONSIN UNIFORM BUILDING Application No. Labor and Human Relations PERMIT APPLICATION 1180°Ct 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 Wisconsin St?tute 101.63 101.73 programs [Privacy Law, s. 15.04 (1) (m)]. PIEROOKEREgoesixtvi:iilsirconstr 0 HVAC 0 Elec 0 PI bg ii 0 Other: Owner's Name 1 Mailing Address Telephone No. T'1/2 7 gr$ 4, s, /04.:...„ ....,h ri 0 kt, ku f' ( Y/r2 3/- V920 I Controtor's Na e: aCon 0 Elec ID HVAC D Plbg Lic/Cert # Mpiting Addr9s6 Telephone No. 4 ..5efr` ( ) 23C- Contwctor's-Name: 0 Con WElec 0 HVAC 0 Plbg LiciCert # 4fra , . Miil rs Telephone No. c--14-$44 1 Als ri 420 _3 s 7, Contra r's Name: 0 Con Or efi-(VAC 0 Plbg Uc/Cert # • Ming Ad -res? 5 Telephone No. .7" ,S eZ-4 Pr o/ Contra. Nime: pig ,Con 0 El.e Lic/Cert # Maili99 PA:yes 21 i Telephone No. ‘ 1 11 , l'ef"‹ e atts-ra-ali PROJECT LOCArvoN j tot Area Sq. ft. 1/4, 1/4, Section , T N, R E (or) W Buildinq,Adtess ,, / e Name e f....„1 . ‘..e4" Lot No.? Block No. f-f ° I - J K Zoning District(s) Zoning Permit.No. Front Rear / A , Left / it Right / , 4, .5 Setbacks Z "... ft. g9 r ft. / a ft. '7 0 VMAKri::::::::::iiiiiii::::::::::::::::::::::::::::::::::::iiii:ii:::::::::: _LaiigiOCCUMINCY:ii:::IP:a6ORKAC:::g:::V:HvAcoxpmgotriiiiiii!iii1:42MetartaloURaiiiiii:::::::::::iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii::: Anew - 0 Repair _.Single Family Entrance Panel Arfoiced Air Furnace Nat L. P Oil Elec. Solid Solar 0 Alteration 0 Raze 0 Two Family Size: 200 amp 121 Radiant Baseboard or Panel rUei Gas ['Addition 0 Move 0 Garage _ Service: 0 Heat Pump Space Htg 0 0 0 0 0 0 Other (print): .Nrinderground 0 Boiler fl overhead ..Vt, entral Air Conditioning Water Htg16001:10 0 0 Other 0 Other 0 * Dwelling unit will have 3 kilowatt or s t a I I electric t r o l op t i space oo i s heating sealing eq ui p te Constructed .Concrete : ' 11 :VnUMEHNO::::::::E:::::::1:::::::i:::::::: i 0 T77 1 7077 . 7 vot 0 Manufactured p T . ''';eWer of joints. 0 Blower door test. 0 Exterior air infiltration barrier. Unfinished Basement is D Other NIV1unicipal giii!!!ii!iiiilVt.0 Ptri- Story IiiCi300:11:iiiing:ii El S p e e T it N Living Area /57 2— Sol• ft- ID 2-Story 0 SeasOnal Envelope BTU/HR L1 WV Infiltration 9 o 4 BTU/HR Permanent 0 Other Garage b ..... 0 a Sq ft. D Other RIVIunicipal Utility 44 ig,...0...__Stattfiki;fRigcqggii:PORM Plus Basement . 0 Private On-Site Well $ Aga Geo, o• 1 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 . . d, on the Department r municip lity; and certifies that all the above information is ccurate. APPLICANT'S SIGNATURE 4 t DATE SIGNED APPROVAL CONDITIONS CONDITIONS Thi4r it is issued pursuant to the f011owing conditions. Failure to comply may result i suspension or re • :tion of this permit or other penalty. ) ¥4 in ,.(2 reY, ; d •-• Cheek, i 1 IV1411 542,161 .// 7..got) ‘,.•^. i t..47. , .+14' iN 0 c hr, (-1/45 1 441'7,0 r). c" a 't 1., A-k-1 ■ .-. I 'fob k- o-c ef.. c.... C.-4'*1NA° .e - D Town 0 Village City 0 CountY 0 State of Municipality Number of Dwelling Location: .......F•sl.t.9.FIN. J1) (:)5\I,N, 7a-Q_6_ ... . tgwinasii!::::W,A;:i014)0....0:MitgRA:r iiiiiiiiiiiiiiiiiiii.8:::::::::::•:::::Siiii,:!::::1:::::::::::1:10:::iii:010:91::::::::::. b 4t ISSUED :;::il:kLA Plan Review 911 Construction Inspection $ 111[114-1VAC Name ,i,",. / Wis. Permit Seal $ 'NO 0 Electrical ' Other $ - . 0 Plumbing Date 11 —' 2 — Total stC $ ..... to ISDNosion 1 P 4 i 1 6 Cert. No. 3c SBD-5823 (R. 06/94) WHITE - Issuing Jurisdiction YELLOW - DILHR GREEN - Inspector PINK - Owner/Agent ' 3 43 &so. Z0-0 CATE NAME w, � a S Q,,O v$ iy�,�� -c ADDRESS LOT 1 0 BLOCK WARD SUBOI`,l. “S ZONE STREET NO. 14.fO5" \,JQ4Nno.),r C-.. rcke_- LOT DIMENSIONS SIDEWALK EXISTING YES 0 NO a BUILDING GRADE ELEVATIONS STAKES SET AT SITE ; .)0.1 - , 2(; ,I9 /5 gY FE!; $15.00 �'�^•v a�i�- ��vTO1�i DEPARTMENT OF PUBLIC WCRKS I, the undersigned, owner or agent of the above describeC properly agree To have the grade estaoiished before excavation has commenced. 0072. 6 6 / City Of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address 1 ri S .. _ � ( - Own eras Name T72AAA p o Dvae,1.4per t.,4 'S Name of Subdivision t4 �S. n k v, , , C_\ rc-k2 Lot # Bldg. Permit # J©J q' No. of Units Fee Required t(pc) Fee Paid Inn Owner signcture Date l� Z/9 Inspector's signa re D-112 Date I D - Parks Subdivision Improvement Accts. 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