HomeMy WebLinkAbout0036194-Building 110 . .
CITY OF OSHKOSH N ° - 36194
PERMIT — APPLICATION AND RECORD
TYPE: BLDG p HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS
1D5 - iki \G€ L- � - PLAN NO. rj- /s9 /q3 4
OWNER RoC A' R ARA 1■\SC)0
DESIGNER n ` ` vv ,� ,
USE /NATURE OF WORK V s(N E 1 l (0..) t A�Tr ,c. ` , 6 ro
BUILDING CONTRACTOR e/ / / �� �. y / R�,LD6 S ,�l� )
Size Sq. Ft. 1 `17(7 # Rooms F� ^a # Storiess I Height
Foundation Class of Const. r, Occupancy Permit yS
HEATING CONTRACTOR
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
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 $ Tff 4CC) Permit Fee Paid $ .��7 1 5- Park Dedication $ l � o aga
ISSUED BY -- jr-9.-LA- �rZ Date q/30/93 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
018IGNATURE ∎J o.� _- •
AGENT /OWNER DATE
ADDRESS / 7& , Co �c6 f 0 ''1/ -- 3il S
TELEPHONE #
•
F/ _ 1 s'q 91g
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM 2619
Labors Human Relations
Division of Safety & Buildings BUILDING PERMIT APPLICATION NO.
Box Madison, Mad n, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
PERMIT RE'IUF,.STE CONSTRUCTION ❑ HVAC El ELEC ❑ PLUMBING ❑ OTHER:
Owner's Name Mailing Address Telephone
/ 1I7A
Contractor's Name Mailing Address Telephone
� / 14,0 #- // � 6 n / 1 g —r ..79.5'
Are
P ROJECT LOCATION
: :., : :.:..:: ::..:.::.:: :.:. » :: , # � S ft- 'h, '14, SECTION _ , T N, R E (or)W
Building Address ......................... Subdivision Name Lot No. Block No.
I MC .IN• Ae.,v 411 Te1Yr /e. A VA SY
Zoning District(s) Zoning Permit No. Front Rear Left Right
Setbacks ft. ft. ft. ft.
. ;PRIJEI x : ; :. ::.::::. .: :.;.Occ i :.:8 ; ELE i : : : ::::9 : *$VAC JPMENI' 1.2 ENERGY SOURCE :
r New ❑ Repair iii Single Family Entrancl Forced Air Furnace Fuel Ga Nat. L.P. Oil Elec. SolidSolar -
Alteration ❑ Raze ❑ Two family Size: OAF atftp ❑ Radiant Baseboard or Panel s *
❑ Addition ❑ Move ❑ Garage Service: 6.6 ❑ Heat Pump /'ridd .. id Space Mg. ❑ ❑ ❑ El
❑ Other ❑ Underground ❑ Boiler / • Water Htg ❑ ❑ ❑ ❑ ❑
❑ Overhead ❑ Central Air Conditioning
❑Other ❑Other * ❑ Dwelling unit will have 3 kilowatt or
>s; ...::: .:.......:...:::; .::. o:;:;.::::::: more installed electric a heating
:.:.:. .::<,:::::. -: ect space equi .
p
C oncre te , Infiltration co ntrol option ['Full sealing
... .. Site constructed '� " ><P#;� » > > > > > > > >« << ptton is:
❑ Manufactured ❑ Masonry Sewer 7 T° S of jon ❑ door test. ❑ Exterior
':?!+ SEA' :':fN��'. >'.'. > >! >:' >': >':'':' �T J
❑Treated Wood � Municipal / air inifiltration ts. Blower barrier.
q ❑ Other
❑ Septic
Unfinished Basement f� s . ft �"r.::<ST'# MES:<: 7V< Gate�lat�d #:. .: . .:<>
Permit No
1 Story $«<< » » > > >> Envelope 1 BTU /HR
Living Area 4W4 Sq. ft. D
2-
Sto
❑ Seasonal 1 �� <1IC!`A�`M*#� ' <'<'[ >' > >> 9
rY C] ....... Infiltration Q� f 9 BTU /HR
O ❑ Other �9 Permanent
Garage `� I� Sq. ft. ❑Other � Municipal Utility 'll* :ES� I�� GO$T
❑ Private on -site Well
Plus basement $ i ��4
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 Department or Municipality; and certifies that all the above information is accurate.
SIGNATURE OF APPLICANT .i ✓ % _ DATE
CONDITIONS OF APPROVAL This permit is issued purs -,,- to the following conditions. Failure to comply may result in suspension or
revocation of this permit or • her penalty.
9 .$ &n 118ZS.5 p.A/05
a.) So(,... 672t5/o,U 44E.s'Sc4't / GN/2 Zl. /z5,
Municipality
TOWN N
'< >. ❑ ❑ ITY umber of Municipality Number f Dwelling
❑ COUNTY p ty b o
...._: : ❑ STATE ❑ INDEPENDENT Inspection Authori Location, if different
RISSI<3 TI N i `,
S milAri �r . . ; lilt�34lll RM:`.11Rlf ll : : EE '!'Si, t 3
Y
n - • nstruction
Plan Review . $ L `_ '� O, E HVAC
Inspection . $ Electrical
NAME
Ins
p ❑
Wis. Permit Seal , , $ �° ea ❑ Plumbing ] L DATE 9 [
Other \
TOTAL . . • $ �De� �MrS tai r ! � cO CERT. NO. `� OR
SBD 5823 (R. 8/90) WHITE — Issuing Jurisdiction YELLOW— DILHR GREEN — Inspector PINK — Owner/Agent
—"`- Revised: 8/S
�
ZONING /LAND USE COOMPLIANCE CHECKLIST
JOB LOCATION: )005 F) LN ZONING:
PROPERTY OWNER /CONTRACTOR: - jaNn/ J ./00 c /(10 ?S
CONSTRUCTION DATA: 4NEW CONSTRUCTI{N ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
Ai ER) S'1A)6(.E n(L .., ird) Aa7 LAAJ) C 6 '
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COMPLIANCE CHECXLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
_ Use
•
_ Lot Width
_ Lot Area
Fioodplain
Front Yard
Side Street (frtnt 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
•
V Vision Clearance
Height
REVIEW AUTHORITY:
The Director of Community Development, or desi nee, must 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) Requir
REVIEWED 3Y: %� OATS: iff/
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD Address 1 O L S C LN
Owner's Name , ::3a �
Name of Subdivision it'Vbt jlL»U' FLT Noi
Lot # Bldg. Permit # ,S619y
No. of Units
Fee Required
Fee Paid 4r/o "S_).
tot
Owner's signature 6, V __ 191._„_. Date
dor Inspector's signature % !,4 L ' Date cJ '/93
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
DATE 9 / q
NAME (`}, g ADDRESS
LOT 5`7 BLOCK WARD
SUMP/. 2A<tJ, ,ltOA/ 1t /)U * s ) ' ZONE /
STREET NO. / -3- 5 deZ d LOT DIMENSIONS
SIDEWALK EXISTING YES LJ NO G ----
BUILDING GRADE ELEVATIONS STAKES SET AT SITE ' -
..
0 9 ,I9 9 3 BY &Ale
FEE; $15.00
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade estaaiished before excavation has commenced.
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