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HomeMy WebLinkAbout0045034-Building 11D CITY OF OSHKOSH N ° - 45034 PERMIT - APPLICATION AND RECORD TYPE: BLD HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING u- ___ FLOOD PLAIN HEIGHT ADDRESS 1 ` os LA-131/4 L A E P LAN NOB — O � a <p OWNER eLP1/4S\C u©Ok � V DESIGNER USE/NATURE OF WORK N) GU-- � l� 6LE ` r ` t.L J Am u m C J� - L owe LGv ��Isi -1� ��� �. CGS t E OFF fiim«y RcM I ,�-, J & 1 AND mks ) BUILDING CONTRACTOR lall% SSW__ `ES r- .1- - \a Size kIL. • Sq. Ft. \ C # Rooms 6)- (i3R # Stories Height 1 b Foundation CONC-C Class of Const. Occupancy Permit HEATING CONTRACTOR - 5ZE Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR .MR. Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR D _____ BT _ WH _ Disp — WSoft — CBasin - Lav — Sh — DW — DF _San. Sewer _WC _ FDr _SP — Ur — Storm Sewer — Sink — LTub — Eject — SS — Water Other FEES: Valuati O Permit Fee Paid $ t k a - FC) Park Dedication $ t c3 6 ` ;7 ISSUED BY ` p� Date 1 t ‘ 4 Fina(/O.P. In the performance of this • rk 1 - - e to perform all work pursuant to rules governing the described construction. ,42 ---- 1 SIG . U' ---+-A%- v AGENT /OWNER � o � all � DATE W I c t / � /U1 al TELEPHONE # 1 44-5;m5 . E Dss 5 Se R Wisconsin Department of Industry, WISCONSIN UNIFORM BUILDING Application No. Labor and Human Relations PERMIT APPLICATION Lk 5 0 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 Wis`consin 101.63 101.73 programs (Privacy Law, s. 15.04 (1) (m)]. n .; .��CI�I'�'.R.•EU"�TR�� s ❑HVAC ❑ Elec ❑ Pllag---Ntrosion El Other: Owner's Name Mailing Address Telephone No. C► BSI Z— 1-101- PS y 4 -do....6 - (L1 tui ; -$6e0 Contractor's Name: ❑ Con 5I{Elec ❑ HVAC ❑ Plbg Lic/Cert # Mailing Address Telephone No. ubs -1 r+ -- ....rum - nor -il�Cr t>Ptic.-t't- ( ) IN - zzqet Contractor's Name: ❑ Con ❑ Elec HVAC ❑ Plbg LidCert # Mailing Address Telephone No. z Me- - n 1 1 TetI4h A 'FA vex ( )148 6414 Co tractor's Name: ❑ Con ❑ EI&c ❑ HVAC I yIbg Lic/Cert # Mailing Address Telephone No. %I V,,.1 Rte -1 eA 4 tom, to (..437 _,../ L.e - ( ) Z'3 t -c.lic Contractor's Name: ❑ Con ❑ Elec ❑ HVAC ❑ Plbg Lic/Cert # Mailing Address Telephone No. ( ) i> t C :r i t0 Tio I > it L t Area .:.. 10 1 S q ft 1/4, 1/4, Section , T N, R E (or) W Building Address Subdivision Name Lot No. Block No. 1105" L4N-A -al t_.t,ltz--- c- ov-o.. 0 - 406x SS Zoning District(s) Zoning Permit No. Front Rear Left Right R-1 Setbacks Z ft. ft. 1 s ft. 1.5, ft. 524New ❑ Repair aSingle Family v Entrance Panel ,Forced Air Furnace Nat. L P Oil Elec. Solid Solar ❑ Alteration ❑ Raze ❑ Two Family Size: Zoos amp ❑ Radiant Baseboard or Panel Fuel Gas ❑ Addition ❑ Move ❑ Garage Service: ❑ Heat Pump ❑ Other (print): j;)Qnderground ❑ Boiler Space Htg?J' ❑ ❑ ❑ ❑ ❑ ❑ Other ['Overhead ❑ Central Air Conditioning WaterHtg j ❑ ❑ ❑ ❑ ❑ $ ❑Other * ❑ Dwelling unit will have 3 kilowatt or t fi �' `' ... more install d electric space heating equip. to Constructed oncrete r' P' ...... "" ' '�� #��.�I�II >> ` > € <' €` ? »> > Infiltration » acontrol ;:, �] M anufactured '�j M asonry W •••• • � option is: ❑Full sealing "` ' ❑ Treated ood Sewer of joints. ❑ Blower door test: ❑ Exterior Unfinished Basement >.: ::» r .:,::. : >:• % » » »::•:; air infiltration barrier. unici Sq. ft. ' ` ES�.'<: ?. <:>` %.<. > ❑Other Pal :< :;.. : a tic s: >::::::<::o:': : ',•':: ••: S : •. %' �r: : «:; : ;• , ;: ;:; ;< ; > : `�`>': . ❑ 1 - Story : ':[': : n <�`'' :.'` > > ? >53 #i # i ?:zz � .:::::::::::::+."•: ��' �; �; �.t,...� Living Area I Q.i,�*y• Cr, . ft. ❑ 2 -Story ❑ Seasonal Permit No. Envelope 2 ( BTU /HR >I : :::VAT :: iz Infiltration 1S � . 0 (o BTU /HR Garage ❑ Other ermanent : * .:•:::.: : >` >'< » >< "<< # { 99 g Sq ft. r:2 P unici aI Utility ❑ Plus Basement ❑ Private On -Site Well $ 80 000 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. APPLICANT'S SIGNATUR DATE SIGNED 5 - APPROVAL CONDITIONS his permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. 1 . 1 L I N a(a. ..tL, . , c s . ( on) ME-,45U) � `� . ' - L Qt. 0-S% a.) r'6c1...N■stk - MOSS " Alk ,S e ZtA3Si c" FOR me .3 t N)5 � 3_ 3 ti . �Et t1' C.V. � Jet - -).PL `Z511) r Town Village e it ❑ Count ❑ State of: 9 ❑ o Municipality Number Y Y ❑ u ber of Dwellin Location: P Y JURISDICTION .... d 7- O G Plan Review $ qo Wonstruction Inspection $ ❑ HVAC Name W ) e.SI■tov is. Permit Seal $ 5O ❑ Electrical [ f $� q Tota l Other $ El Plumbing Q Q Date $ '70 .51.#0 rosion /ST ` C� Cert. No. 4C00e SBD -5823 (R. 06/94) WHITE - Issuing Jurisdiction YELLOW - DILHR GREEN - Inspector PINK - Owner /Agent ( J 1 /� V � S ZONING /LAND USE COMPLIANCE CHECKLIST e-/ JOB LOCATION: I LA G lA 7_ ZONING PROPERTY OWNER/CONTRACTOR: el-Pe. T�JVLE. - ''"2L--- CONSTRUCTION DATA: -4k New Construction Addition Alteration TYP OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) 7� 4 �(a COMPLIANCE CHECKLIS 2 2 -' S� 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 � / " g - * 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 _ A / 7 J '"- REVIEWED BY DATE: .Y CATE S' /� 8/ NAME i SS/C. //ONES UM ADDRESS LOT sS _ BLOCK ' S 0801 v . ktAi /20 ZONE STREET NO. 05 676e C/�/o LOT DIMENSIONS SIDEWALK EXISTING YES NO 0 BUILDING GRADE ELEVATIONS STAKES SET AT SITE ��}�� FEE: $15.00 '19�._BY OEPARTMENT OF' L LIC tWORK, 1, the undersigned, owner or agent of the above described grade established before excavation has commenced. 'ro ert a gree ro have the P � • 411.1Nors City Of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address //0-C ' A ` Of 4Ai Owner's Name eiAss/ e, / n1ES y MM Name of Subdivision Fooq iTtnHA) ROC - R Lot # J.r—s' Bldg. Permit # qSo y No. of Units Fee Required 4.'00 Fee Paid 11 l 00 Owner's si • --w.I __ -_ � v- �^�!`� Date Inspector's signa ur A !.►. ∎03 ■_ . � i � Date Sh al 7 ) Parks Subdivision Improvement Accts. Rec.: 352 -rii.i ' ` \� ' ' ` . ' -. ' � ' ! / | / / / / • ' �