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HomeMy WebLinkAbout0023613-Building CITY OF OSHKOSH N°_ 23613 PERMIT — APPLICATION AND RECORD TYPE: BLDG A HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING '\'I FLOOD PLAIN HEIGHT ADDRESS PLAN NO./h / °4 'k0 69 /ft OWNER 14-40/ / 44-4-C �.r -.T i DESIGNER �; USE /NATURE OF WORK )IC14) ? jig i� 4,1 4 BUILDING CONTRACTOR Q1417(.44-1 , � �?� L / ` L G(/! „..9),e444,6,0),;, Size Sq. Ft. 3 o O # Rooms # Stories / Height /3 / Foundation e."7• Class of Const. P Occupancy Permit A HEATING CONTRACTOR 13A- Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR Cm� Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR 26 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 $ 30 �oC " a Permit Fee Paid $ /0 7 • ©0 Park Dedication $ X t 0 0 ISSUED BY Date to 1319/ Final /O.P. 1 -/ 5 - 9), In the performance of this work I agree to perform all work pursuant to rules governing the described construction. T / / SIGNATURE (�!'�� AGENT /OWNER DATE ADDRESS TELEPHONE # /I/ac‘ID69 /, Depart en of Industry, WISCONSIN UNIFORM Labor 8 Human Relations Division of Safety 8 Buildings BUILDING PERMIT APPLICATION NO. Box Madison, WI 53707 APPLICATION Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO. PERMIT U W : CONSTRUCTION E HVAC ❑ ELEC ❑ PLUMBING ❑ OTHER: Owner �Na Mailing Address Telephone Co ,,ff coo jj s__Nam Mailing Address Telephone £c a o rr!� �� .o o 7,k4esek /ii 6Q S'Wo ( "2-3 77P :: .«:::>:« : <: >: >:: >:::: ::> ::: :<::i::: Lot Area < ECUL << ......... .......................... Sq /., Y. SECTION . T N, R E (or)W Building Address Subdivision Name � / � Z // Lot No. _� Block No. /04 mac/ 7 Zoning District(s) oning Permit No. Fron r Rear / Left r ( Right �' ie Setbacks S ft. O `r ft. f S ft. /� ft. PROJECT `?:: :::::::.:::.;; .:6: ELE TRE. 1L 9.:':HVAC EOUIPMENT 12 ENERGY SOURCE K New ❑ Repair Single Family Entrancg Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar Alteration ❑ Raze Two family Size: / amp N Radiant Baseboard or Panel Gas ❑ Addition ❑ Move ❑ Garage §rvice: ❑ Heat Pump Space Htg. ;00000 ❑ Other Underground ❑ Boiler Water Htg. ❑ ❑ ❑ ❑ ❑ Overhead ❑ Central Air Conditioning El Other Dwelling unit will have 3 kilowatt or ❑Other! %< `F< mm , more installed electric space heating equip. Concrete option ❑ Full sealing ..:: " ..:... .:.:. > Infiltration control o lion is: ...� ...... �..,.:..::- :: Site constructed ' 1E ><; >«<<:.: Manufactured Masonry er of joints. ❑ Blower door test. ❑ Exterior " � ❑ Treated Wood air infiltration barrier. 4 S�'IES::: ; ❑ Other rMunicipal e tic P 13 ' :HEAr LOINS Galculakd} Unfinished Basement Sq. ft. p -:::.:: .. ..:...:.:.:::.:::::.::..::::::> Permit No. t 1-Story Envelope Envelope b 9 ' / BTU /HR O Living Area / 3 0 Sq. ft . 2- Z ry Sea sonal '��..�`���. ., .. .. Infiltration 59. (1 BTU /HR ❑ Other Permanent Garage Sq.ft. ❑Other � Municipal Utility ' �: � ;:.ESTI�;,D�I�(;�;j'I': . ............................:...:......... .....::::.:...:.:............. . ... ❑ Private on -site Well / ' ❑ Plus basement . $ T.5; 00 0 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 implied, on the Depart nt or Municipality; and certifies that all the above information is accurate. SIGNATURE OF APPLICANT :-._ DATE 4-c-7/ CONDITIONS OF APPROVAL This permit ist issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this • = rm or other . enalty L 0 /: 1 li 10 TOWN Municipality ❑ O N a Number ❑VILLAGE CIT 0 p ty of Municipality Number of Dwelling :<<::::::>::: 0 STATE ❑ IND PENDENT Inspection Authority Location, if different OF: (1� Zo_.- . 1st -4 -- - - -- g. PERRA... R .;.. WIS.;UNIFORM PERMJT P pc E SEAL:NO. f I ISSt Y Plan Review , , , $ 441 0 .O Constr;'° n n HVAC �i / NAME Q\ Inspection . . . . $ Electri w t rit't Wis. Permit Seal , , $ 30 •' ❑ El Electrical 10 - Other $ ❑ Other �.� TOTAL . • • $ -70 .0 0 CERT. NO. o S S 0 SBD5823(R.8/90) 0 (3�� WHITE — Issuing Jurisdiction YELLOW —DILHR GREEN — Inspector PINK —Owner /Agent Revised: 8/89 ZONING /LAND USE COMPLIANCE / OMPLIANCE CHECKLIST JOB LOCATION: �S(,d ZONING: oe PROPERTY OWNER /CONTRACTOR: ,44,E , a52 c4 e74 CONSTRUCTION DATA:EW CONSTRUCTION ADDITION ALTERATION PARKING LOT TYPE OF PROPeSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.) 4111WV z Z / �/ • COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT DEFICIENCY /COMMENTS Use Lot Width Lot Area Floodplain Front Yard Side Street (fratt yard ) Rear Yard Side Yard (R) Side Yard (L) 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, m st 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. PPROVED DENIED Plan Commission Action Required Variance(s) Required REVIEWED BY: I / DATE: G C� City of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address //C24;40 eP4 Owner's Name -i iLLlA 9S (4c/: ��rt, .CG Go?v Name of Subdivision L a- e40 .le/�,G44il1- Lot # 6 Bldg. Permit # ; No. of Units / Fee Required ado, d0 Fee Paid /00 .Q 0 Owner's signature ( Date 6" S" Inspector's signature -Date //?/ Parks Subdivision Improvement Accts. Rec.: 362 -041 DATE 6/3* NAME ADDRESS LOT 744(2 BLOCK WARD SUBDIV.2.no/e(41 406%. /44,, ZONE STREET NO. /6 " /4- ° .y ■ LOT DIMENSIONS SIDEWALK EXISTING YES Q NO BUILDING GRADE ELEVATIONS STAKES SET AT SITE _ D 3 ,19 9j BY FEE: $1 _ 0 1 . -o ZG 1 1 Cam/ DEPARTMENT OF PUBLIC ',N K.S I, the undersigned, owner or agent of the above described property agree to have the grade estaoiished before excavation has commenced. 00 /1342 ,44,0 H d' ' ;, • CD . • o W � o 1.) o a • 4-1 N !I H N o a , 0 o N i a . ' 0 0 ? a N •• c) ' x O 0 3 .0.0 0 I . (0 ( 1 , -- LT• 4 w c c i i . PC 3 W N rt N A . , �' _ . __ ( m A H v a. . . cn Q �9 a o . W J i \ r A H 13 2115 n ~ M A �. W I; • U 0 V) • O M < v) . J . I, W W J W ! • • W \\\\07 .. „ 1 J Q 00 W . do i I . . 1 I- 7 : ' ( 09 ) >< ( ) >c S2) > ,�h � , _,Q1 4 • • IW J • W • - /3—H77' . Nil J -1 J W W �.. 111 - - (2-)tij ( ' �� 1 V 1.J (1,ZiaS