HomeMy WebLinkAbout0046648-Building X1
CITY OF OSHKOSH
N2 46648
PERMIT — APPLICATION AND RECORD
TYPE: BLDG* HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING R 1 FLOOD PLAIN Gu* HEIGHT D/
ADDRESS L. SS 'Lc= cv`tist"' L n . PLAN NO. A ' s ' /
OWNER t t. hi... 14, 1 (-2r,
DESIGNER W 1 5 L , ✓v e.. 1
y
USE/NATURE OF WORK A 6L ✓ /; A"- 4 411 -, 4 ra f ..
BUILDING CONTRACTOR LC:- L A t C3 vlr L-P 2
Size `rc 3 ' Sq. Ft. # Rooms h t;) 13,-1-14 # Stories l Height
Foundation f .-1 'e....2 Class of Const. Occupancy Permit /cc& t P
HEATING CONTRACTOR rite m A z-
Heat A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR Z W S LE c_—T2.—_-
Electric Serv. New) Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR (--E-4 PL_c_4 W L ( r ' ,
- BT — WH _ Disp _ WSoft — CBasin
- Lav _ Sh _ DW. _ DF _San. Sewer
— WC _ FDr _SP _Ur _Storm Sewer
- Sink _ LTub _Eject _SS — Water
Other
i —J
FEES: Valuation $ 1 . � � , Permit Fee Paid $ � 1 a a Park Dedication $ lQ
ISSUED BY D Date 'r I 6 - c, 5 ^ FinatO.P. 1/'.tc L - L
In the performani. 1 of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE A IL/ u. I l i j `p cj'
AGENT /OWNER DA
ADDRESS
TELEPHONE #
Wisconsin Department of Industry, WISCONSIN UNIFORM BUILDING Application No. _
Labor and Human Relations PERMIT APPLICATION
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
Wisc nsin Stat to 1 1.63, 101.73 programs [Privacy Law, s. 15.04 (1) (m)].
> : R T R .EQu T D <<; onstr HVAC El
....... :::.::: :<.:: �::;:;.;:.;:.; >;::.....;;;:: >:» ❑ ❑ ec ❑ Plbg VErosion ❑ Other:
..............
Owner's Name Mailing Address Telephone No. •
nil i 1 of 1. ro �, I 15`12 S. ®c- A If./no �, 06447s� C`t4t( ( )�177-= 7710
Contractor's Name: gCon ❑ Elec ❑ HVAC 0 Plbg Lic/Cert # Mailing Address ', Telephone No.
l..e..±tc 'Qi A - PQ &»( 3i9 OCkkott 5 ' ( )
Contractor's N me: ❑ Con 0 EIe 'HVAC ❑ Plbg Lic/Cert # Mailing Address Telephone No.
r"
.C.. r►� �t t` ( )
Contractor's Name: 0 Con grElec ❑ HVAC Q Plbg Lic/Cert # Mailing Address Telephone No.
Zw•iCS ( )
Contractor's Name: ❑ Con ❑ Elec ❑ HVAC ❑ Plbg Lic/Cert # Mailing Address Telephone No
EC >#�3 " `I...'�. N�<::Z<:3 Lot Area
:•x: ::: :s::;p:I i/ ,(C'cj Sq. ft. - 1/4, 1/4, Section , T N, R E (or) W
.... :.......
Building Address .
Subdivision Name r r Kit, + Lot No. Block No.
/ ( 3 L c e -- L.� ,241J Ab�.n .' 4 o FIp A .3"—',
Zoning District(s) Zoning Permit No. Front Ree Left Right
Setbacks PS ft. I CC9 ft. a 0 ft. 13.5 ft.
:: CY.:. >&,_: f�. EC�' �i. �. . . : . t, �l: fr. .:. t�IWIE�I 'i`. :...;;. ..:: •::::>:<:<::»:: >:: >:: »::::;;:::: > >: >:: »:
. iew ' ❑ Repair m le Family Entrance Panel orced Air Furnace Nat L. P Oil Elec Solid Solar
❑ Alteration ❑ Raze 0 Two Family Size: Apo amp ] Radiant Baseboard or Panel Fuel Gas *
❑ Addition Q Move Q Garage S rvice: ❑ Heat Pump
Q Other (print): OGnderground Q Boiler Space Htg ❑ ❑ ❑ ❑ Q
❑Other Q Overhead Q Central Air Conditioning Water Htg 0 ❑ 0 0 Q
}�; st ,; r ..
.:; . id ❑ Other * 0 Dwelling unit will have 3 kilowatt or
, site Constructed ❑Concrete aa�� more installed electric space heating equip.
::;• :::
❑Manufactured ,.Masonry •••••�•���A ��� :.. ;;; Infiltration control option is ❑ Fall sealing
' `'`'' "'`' • `'< Sewer of joints. 0 Blower door test. ❑Exterior
;,,., • . .,•., ::., . ❑Treated Wood air infiltration barrier.
Unfinished Basement q. ft. STO RI 0 Other BTU /HR
unicipal s »s: ;::;: :::: :::: :.;:.;::.;•.:,:: ;:;,;,,;.•:.: < >: : >::..;:.:;:;;.;...:::::::.
Living Area / f
::: >:; : ' : : ::::::: <::.::•::•:;• >::s:::: ❑ Septic : < i:IN " k' ...' . .::. : ` '
Story :RJ::z:::i! >:> Envelope 3
»s::>:<3 •...Permit No. >� S ft. [in
❑ 2 -Story • ❑Seasonal
VW01.1C::,....,'.. ^ ::::T `:? In filtrationo7
Garage , sq. ft. ❑ Other Permanent ::::::..... .............: ; - 70 — If
unici aI Utility Other P
to
❑ Plus Basf
v nt Q Private On -Site Well $ ! ` 0,'
The applicant agrees to comply with all applic bit. codes, sta tes • d ordinances and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, express o lied, on , • epa ment or cipality; and certifies that all the above informs ion is ccurate.
APPLICANT'S SIGNATURE � ,; l, �j" i(
_ DATE SIGNED .
APPROVAL CONDITIONS This permit is is ued pursuant to the'following conditions. Failure to comply may resul in suspension or .
revocation of t is permit or other penalty.
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Village ❑ e
it
❑ County
Stat f•
9 Y ❑ State of: Municipality ❑ c alit Number D
e o Dwelling Location:
������; >�` >;>` � P Y cat n: o
. URISDICTIO Osh 1 4) S k 7 a - °Z 6 C
Plan Review $ L i 0 d C. 7gonstruction
Inspection $ Q HVAC Name f�� c''!'r'.,v1 L) (t(✓
Wis. Permit Seal $ 3c) e+(3 ❑ Electrical
Other $ ❑ Plumbing Date 5—' i q ct
Total
$ OC) erosion 16a3$ '„ s ,
Q • Q Cert. No. n
SBD -5823 (R. 06/94) WHITE - Issuing Jurisdiction . YELLOW - DILHR GREEN - Inspector PINK - Owner /Agent
O
•
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: I�S� La�� C L U ✓\- -- ZONING ! `,
PROPERTY OWNER/CONTRACTOR: 1 /✓vf. -) ,/ c J IV L r'
CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) F a r,
COMPLIANCE CHECKLIST
DEFICIENT COMMENTS
Use
Lot Width
Lot Area
Lot Area Per Family
Floodplain
Front Yard
Front Yard Side Street
Rear Yard
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
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.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: D61. DATE: 1 3
JOB START AND PERMIT INFORMATION
OWNER: trtr IcE
/5 5. 0 41414/0,90 D 2
05A405. �vz �'� -� o
PHONE: 3 3- '? 7 I o
JOB COST: CONSTRUCTION -$
MECHANICALS- $ j k 3 0 o
TOTAL COSTS- $ j ,c„
SIZE: 1ST FLOOR SQ. FT.- 1.
2ND FLOOR SQ. FT.- —
TOTAL SQ. FT.- S(
GARAGE SQ. FT.- SY3 1
BASEMENT SQ. FT.- 1 S
�,
LOT SQ.FT.- 1 1 , Oo
LOT DESCRIPTION: (�r ¶ 2 ■0 A-0 0 N TZo fi c..3-N2 4 k. a 14 , J w e4
ADDRESS: 1 o Sc Lit- -.-v
DIGGERS HOTLINE: DATE- I lq j
CLEAR DATE- '4' War 10 : � kw t
TICKET NO.- " ,.� - 6 S. Z
DATE DUG:
•
GATE r l ( " ;
NAME 1 "�- G � l i 1�', AODRE5S j (` )‹5 L-4.
LOT 5 BLOCK {- WARD
SUBOI V. (2.11411 k r :L ..I M )4 fv. Ihre ZONE
STREET NO./i LOT DIMENSIONS
SIOEWALK EXISTING YES 0 NO Ea
BUILDING GRADE ELEVATIONS STAKES SET AT SITE C o ,I9 FS By G�yi
FEE: $15.00
W
DEPARTMENT OF PUBLIC WCRKS
1, the undersigned, owner or agent of the abo a described property agree ro have the
grade estaaiished before excavation has comm nc d. •
z/'9q/c7
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address ! " vt-e--
Owner's Name [ At,trov-1
Name of Subdivision „R `A-a k g t G
Lot # _Cj; Bldg. Permit # L1 L04
No. of Units
Fee Required /CO
Fee Paid /0C)
t% c�
i ncture 4, .I C /�� Date U ill/(q)
Ownerssg ...�
Inspector's signature i tJ?'i r lJ —'' Date F -19 "
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
1) 461:114? . 1,( 1r 7
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