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Home My WebLink About0017569-Building CITY OF OSHKOSH N9 17569 PERMIT - APPLICATION AND RECORD TYPE: BLDGHTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING' f FLOOD PLAIN HEIGHTIIQ ADDRESS /0 q J v`.-- PLAN NO. t OWNER fCc 1- � /O in_ FA..* DESIGNER ((J� f� USE /NATURE OF WORK /) .. s j „.1 .9 cs- e, l BUILDING CONTRACTOR 0.,J Q- f / Siz Sq. Ft. (c " # Rooms co 1- 2 1# Stories / Height / Foundation •cc.A A61- Class of Const. Occupancy Permit HEATING CONTRACTOR Z 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 , Z k 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 '. ��i / • - mit Fee Paid $ 0 / Park Dedication $ ADO ISSUED BY 4V .. . _� L�r_ Date Final /O.P. z -. f E. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE r �'p zy,-.1-1-1 -! �y AGENT/OWNER DATE ADDRESS ./O a f90/) 1 c%.?.? / ' 7 TELEPHONE # Revised: 8/89 ZONING /LAND USE COMPLIANCE CHECKLIST JOB LOCATION: ie,_ e ZONING: // PROPERTY OWNER /CONTRACTOR: ()`` pL e (-- CONSTRUCTION DATA: >NEW CONSTRUd6 ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, poo , ign, deck, etc.) / /1)t? COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT DEFICIENCY /COMMENTS Use Lot Width Lot Area 4 Floodplain Front Yard /74, Side Street (front yard) i./ Rear Yard v Side Yard (R) Side Yard (L) c . Parking Spaces Building Area �✓, Lot Area Per Family Corner Lot Landscaping Transitional Yard Off-Street Loading Vision Clearance Height REVIEW AUTHORITY: / / / The Director of Community Development, or designee, must approve all p ans, 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 Regyired Variance(s)'Required REVIEWED BY: it , Aar DATE: '3///`(: / 3 — zZ —Udr) f? State Department o f Industry, ustry, WISCONSIN UNIFORM rtment f Ind t / Labor & Human Relations Division of f S afety 8 Buildings BUILDING PERMIT APPLICATION NO./ S Box Madison, WI 53707 APPLICATION Wisconsin Statutes 101. 63, 101.73 $ee Instructions on back of pink copy) PARCEL NO. PERMITRE E E TE <<<< >< < < <<<< < S TRUCTURE ❑HVAC ❑ ELEC ❑ PLUMBING Owner's Name ;:;. :.......................................... ............................... .;:. Mailing Address Telephone .yr 'O IA La. C < ? Z t6;t rk 1 -3v? 7 Contractor's Name Mailing Address 1 / Telephone /9 CU t-' C P ................................................................................. ............................... ................................................................................ ............................... ................................................................................. ............................... ............... ............................... ................ ....... ..... ..... ... ............................. ................ ............................... PR RO�G IV %, '' /e, SECTION T N, R E (or)W Building , Addresss Subdivision Name / V Lot No. _ I Block No. V '7 .i. Arz efa �o P--' I .vL i rf n Ku k ' Cp e r 4. Zoning District Lot Area Front Rear J Left Right tZ ( /1 O4 Sq ft Setbacks ' ft. 7(4 ft. 7 41. ft. 7 ft. <ta :PRO.IEG'� ; . PE :; : I3 ELECTRICA.. Sx *IVAC EI CPMEN 12 ;:ENERGY SOURCE <! ew ❑ Addition ❑ Raze ingle Family Entranpg P ' net Forced Air Furnace Fuel N t. L.P. Oil Elec. SolidSolar ❑Alteration ❑ Repair ❑ Move ❑ Two family Size: amp ❑ Radiant Baseboard or Panel G * 1=1 Other ervice: ❑ Heat Pump Space Htg. ❑ ❑ ❑ ❑ ❑ El Other underground ❑ Boiler Water Htg. El ❑ ❑ ❑ El : ❑ Overhead ❑ Central Air Conditioning 1b aARAGE t CONST `FOUND ❑ Other * ❑ Dwellin unit will have 3 kilowatt or more install d electric space heating equip i to constructed oncrete 'IO I LrUMBING Infiltration Ic❑ Blower door test. ntrol option is: ❑ Fu❑ll Exterior sealing tached ❑Detached Masonr of joints. Manufactured y ewer air infiltration barrier. :VAR : ❑ Treated Wood nicipal ❑ Other eptic 1$ HE LOSS OSlt:1>Is" ed} Basements Sq. ft. t 7� 'T Permit N°'.....,.... Envelope 3 100 BTU /HR Living Area 1-< Sq. ft. Story ❑ 2 -Story ❑ Seasonal 11 : AT : : Infiltration gQ412 BTU /HR ❑ Other ../ Garage _ ��3 sq. ft. ermanent ther Municipal Utility# <!ES'I'IMATED COST ❑ Private on -site Well .�— $ �COp 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 liability, express or implied, on the Department or Municipality; and certifies that all the above information is accurate. /J SIGNATURE OF APPLICANT / 1�/�Z...., ....,.....-t_ DATE ' K46 -- Y CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. t.) >LV- (' d � + - X3 . Municipality Number of Municipality Number of Dwelling ❑TOWN ❑ VILLAGE �I�TY ❑COUNTY P Y P Y 'IN : ❑ STATE CI INDEPENDENT Inspection Authority Location, if different JURISDICTION -- C '- PERPArrr WI&. UNIFORM PE UMjT $ 1! PEEiII 1:3SI1C Plan Review . . . $ /0 "onstruction j ❑ HVAC NAME 4 . ANY/ Inspection . . . . $ ❑ Electrical Y Wis. Permit Seal(s) $ ❑ Plumbing DATE -- --/ mil / - 7" C 7 Other $ ,e1 ❑ Other ' 77 Q� CERT. NO. ` r t) TOTAL . . . $ f� SBD 5823 (R. 04/87) WHITE Jurisdiction YELLOW— DILHR GREEN — Inspector PINK — Owner /Agent City of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address l b - ' - fST �e� /g-■ Owner's Name Qk K e (--- Name of Subdivision i fo c�- K �� . fta� V e rei � Lot # Bldg. Permit # /?..q No. of Units ( /( Fee Required tL.p Fee Paid /0c Owner's signature gate �9G `�1U Inspector's signature Date ? Parks Subdivision Improvement Accts. Rec.: 362 -041 DATE a�b 9 7]::,,Lirur NAME f ADDRESS /?" Z ,U LOT ( I r/ BLOCK ---- WARD SUBDIV. /Ia - c am . T` iLfr, f'�ry � ZONE STREET NO.,/e2 / � _r.� eV— ctiP LOT DIMENSIONS � SIDEWALK EXISTING YES NO2 � BUILDING GRADE ELEVATIONS STAKES SET AT SITE 3 1 ,I9 BY k.N \ FEE: V5.00 Pijj / %//t 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. 4 ei,11 `�`�1` rte I --�--L. 0 1. 0 - WINNEBAGO COUNTY HEIGHT PERMIT CITY OF OSHKOSH # /r'3 OWNER: frC4 , QKGtr ADDRESS: i`',C k ,. .,.,?7 ..ostt,.:.:74 ' TELEPHONE: 73C 3 0? 7 ADDRESS OF PREMISES AFFECTED: / o 4 j HEIGHT OF PROPOSED STRUCTURE ABOVE GRADE: ( 41 i" COUNTY USE ONLY EXISTING GRADE ELEVATION: 7:19 MAXIMUM ELEVATION ALLOWED: rio / APPROVED: YES Q NO J COMMENTS: CITY INSPECTOR: / /i ct TELEPHONE: _ ' DATE: 37/9/9c COUNTY INSPECTOR: TELEPHONE: DATE: White copy Yellow copy-Town; Pink copy-Owner