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HomeMy WebLinkAbout0015663-Building i i CITY OF OSHKOSH N°_ 15663 --44 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING p-t FLOOD PLAIN_e HEIGHT/tie ADDRESS 2e-C ' �-12 a - e % 1 - " PLAN NO. bl-P_S- 7 k OWNER P r 1-"e l ` - - Z t J hre It t" T-? K. a S& L DESIGNER USE /NATURE OF WORK C.J MI' BUILDING CONTRACTOR &2 «9 ,/ Ct pri / Size' S F -� /Y # Rooms (� C Stories ( Height / Foundation pclA"s Class of Const.. Occupancy Permit HEATING CONTRACTOR 13 4 tr — P.24-- ! `; Heat ❑ A/C ❑ Vent ❑ Fue'I /System Heat Loss BTU'S ELECTRIC CONTRACTOR D t^ r Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR i (TIC bA. _ ka EP tt 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 $ • 41 "© .1 Per- it Fee Paid $ / IV Ni Park Dedication $ /O ISSUED BY I '�•�-� / Date ��� `/ i Final /O.P. 4 / In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE I t - / Iii. . AGENT /OWNER gijCIAL ADDRESS TELEPHONE # u � Zetatro.= USE oci PL.ALr V+'iGG ISi t. c Building Permit # Zouis ( q_ Non Confo'rminq Job Iocatiazi j y� -/ v-P u Int =mei= PlyOwen /P 2, 9ii FZ Lat Ares. CaISTRU=Cti DATA Describe Mc*: Afier-o Xner caampo=cu A°0I -__ A Accessory Ebildizq Pool . 5.13 g1h Panay Naas D•cr/Patio lAr -Fmmi ly Boathouse _ _ Sign _ � _ *Utiility Structure _ Porch Ocumll Other COMP=ANCE CC'S Deficiencr/b_ Dte rat 17 17 Matz rat Area Fi Tai„ • neat Yard Baer Mud •••7„....„. side Yazd (B side Parking �,�,,� lot Area per Samily / %�� _r tat other ) IC=E1== IV. REVIEW AUTEDR=Y The Planning Director, car appropriate dam, rust apprema all plans, apt the- follatirrp (3.) Alterations or interior work when the .use is aaedorating and • are no change of use is pzcposed. (2) MILinterallate items, e:g.., sliding, window, etc., when the use is =forming and when no change of Ise is proposed. Instances wirers ace* =plies with the above criteria, the petnit den hie riviewed by the Building without referral. to the Planning Director. APPADVED T APPBNED __ Plan Conissi,on Action Required __ Variarre (s) Requited III / c RED PS: DA =: f 2 7 crI State of Wisconsin Department of Industry, WISCONSIN UNIFORM Labor Human Relations Division of S BUILDING PERMIT APPLICATION NO. 4S T Box D Madison, Mad n, WI 53707 APPLICATION Wisconsin Statutes 101. 63, 101.73 Seelnst, ctlons on back of pink copy) PARCEL NO. ........ .......... :0 : : .......... : : : : : .. a:]: ............ : ::a: ....... u : : : ........... : : :: ............ ............................................................. .................... ............................................................................. ............................... ............................................................... .................... ............................................................................. ............................... ................................................................. ................ ........ ..................................................................... ............................... PERMIT REQUESTED ; i STRUCTURE ❑HVAC ❑ ELEC r1 PLUMBING wner's Name f / Mai uig Address Telephone 4C 2 f I'C n r 1 ./ -S O Aft . S p cwt 151 0-_..5 ' Sr) 30 Contractor's Name Mailing Address Telephone i;3 f tt.h r ..................:::::......................,::::.................. ..................... .................................................. : .................................. ............................ ................................................................................. .............................. .. ..................................................... ............ ........... .......... .... PR EC1 LOCA ' /a, ' /s, SECTION T N, R E (or)W Building Address Subdivision Nam Lot No. Block No. c --- ��Cip ®l1 e^ f e O v-tc q P /l6' Zoning District Lott Area Front Real Left Right V - ( { a �� Sq. ft Setbacks ft. ft. 7e ft (r$ ft. a.. PROJECT > 8. 7'1PE 6. ELECTRICAL 9. :HVAC E �UIPMEN 12.> ENERGY SOURCE I '. * clew ❑ Addition ❑ Ra Si ngle Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar Alteration ❑ Repair ❑ Move Two family Size:Q amp ❑ Radiant Baseboard or Panel as * ❑ Other er ' e: ❑ Heat Pump Space Htg. ❑ ❑ ❑ ❑ ❑ ❑ Other nderground ❑ Boiler Water Htg. ❑ ❑ ❑ ❑ ❑ ❑ Overhead ❑ Central Air Conditioning 1b GARAGE . C T YPE 7 : FOUPIDATJO ❑ Other * ❑ Dwelling unit will have 3 kilowatt or more installed electric space heating equip. �ttached ❑ Detached .E'Site constructed4Concrete 10 ; PL.UMB INO Infiltration control option is ❑ Full sealing El Manufactured ❑ Masonry Sewer of joints. Blower door test. ❑ Exterior : ARE1 Z'�^ ❑ Treated Wood unicipal air infiltration barrier �(� Sq. ft. S>F# IES:..: ❑ ot h er L7 s eptic Permit No. i3 11EA.T LOSS (tatf tslated) y� Story — Envelope 7S BTU /HR Living Area - 30 Sq. ft. -Story ❑ Seasonal 1. . WATER;: Infiltration v BTU /HR Garage �� l0 Sq. ft. ❑ Other Permanent Municipal Utility 14 ST MATEDCOST LJ Other Private on -site Well $ -5 00 . "19 - 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 liab 'ty, express or impl d, on the Department or Municipality; and certifies that - I the a..ve information is accurate. SIGNATURE OF APPLICANT . . i . / _ 11 4 ` / ° DATE ' ' I 40 CONDITIONS OF APPROVAL his permit is i ed pursuant to the following conditions. Failure to compl may result in suspension or revocatio of this permit or other penalty. 1 I l I- 1711r _ X1 ,f - %�_' rA WWJA� , , ..I" ' Z-.1.- ffrZ ZI. / ... ............................ :ISSUING 0 TOWN ❑ VILLAGE ITY El COUNTY Municipality Number of Municipality Number of Dwelling ❑ STATE Inspection Authority Location, if different JURISDICTION OF IN PEND 7 - 2.,_6 $ PeRM SJ : 1$ i�tiIFO!RM PERMIT PERMIT 1�3sUE i 8�t — — — — Plan Review . . . $ 4 Construction / / � I Inspection $ ■ HVAC NAME > z ` - /x .8 0 _ ❑ Electrical :1 Wis. Permit Seal(s) $ 30 CI Plumbing DATE - qr / Other $ ❑ Other C� /� TOTAL . . . $ -3 . � 3 CERT. NO. / r SBD 5823 (R. 04/87) WHITE — Issuing Jurisdiction YELLOW— DILHR GREEN — Inspector PINK — Owner/Agent City of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address Owner's Name Pere Name of Subdivision ' r\ c [e 1 Lot # / /(p Bldg. Permit # `-C7pCP,3 No. of Units Fee Required /OCR Fee Paid / 00 41r / • Owner's signature �L� 1 ;.ate S 1 . . Inspectors signature (/i „NV/ M�� Date Affj► Parks Subdivision Improvement Accts. Rec.: 362 -041 ! // ��r( DATE j- 27 NAME fc �, r — 0_1%.r `t'Z .�S4 (( �k�ADDRESS 17.50 ,4) . �/ - r I5r- - 1 y LOT lit. // BLOCK WARD SUBD I V . /t� e (e- vcdcoa-c.112 ZONE STREET N0. Z. �-ki SI10 reu' oacP br' LOT DIMENSIONS SIDEWALK EXISTING YES C NO y� BUILDING GRADE ELEVATIONS STAKES SET AT SITE :7 ,1989 BY t` FEE: $>r5.00 Ito DEPARTMENT OF PUBLIC WORKS I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced. fi / !x41 4Itfi Ha woos NolC +74'.06 A t 741.07 i 741.o5 t �z N 1 7.5' , , 1 r 111 z . N J 0 • � So.4 II 11 A + 7Sa. 2s qi v . yb�d ' m i'1 I 1 + 751.7+ 'N _4 ill o 14 s 7.5 < 111- I N + -7s-043 4 t 750.10 5 i7' oq-' q5' Zo . 20 Ve1Fy VER1Fy ■ 7 5 0 . 0 3 t 14 0 . W e Y O ' • '3::1<1.••1 7 5 . 0'1 + ,l — J cc _ L le r / 6GL_Q— -177 z.„A o•P r()