HomeMy WebLinkAbout0034147-Building f/0
CITY OF OSHKOSH N2 34147
PERMIT — APPLICATION AND RECORD
TYPE: BLDG X HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING g FLOOD PLAIN HEIGHT
ADDRESS /// .0 - etioti 44& PLAN NO. pi t3 - 93re
OWNER I. /./.eA"
DESIGNER
USE /NATURE OF WORK ).12 /I Ze d 3Y.4
BUILDING CONTRACTOR a«J7V-A/C P Size /Q
Sq. Ft. 10 a Z # Rooms # Stories 2 Height 24 -
Foundation Class of Const. d Occupancy Permit
HEATING CONTRACTOR de,t4J /
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR iti4
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 494lAhl 14--r"'CC l
BT _ WH Disp WSoft — CBasin
Lav _ Sh DW _ DF San. Sewer
WC — FDr SP — Ur — Storm Sewer
Sink LTub Eject SS Water
Other
r
FEES: Valuatio $ 2 • O Permit Fee Paid $ 3 Z' SO Park Dedication $ ! �o '
ISSUED BY ��.d't Date .S7 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 9 3 (9...9-W--- AGENT /OWNER DATE
ADDRESS
TELEPHONE #
bl 83oS?3,.
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor Human Relations BUILDING PERMIT f It f7
Safety and Buildings Division
P.O. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
Wisconsin Statutes 101.63, 101.73 (See instructions on back of pink copy)
illitiMVIRFFNRRFR: Constr 0 HVAC 0 Elec Plb Erosion Other:
ner's Name Mailing Address Telep a code)
4.1-#1.4.4 qt 6, N. mu-,<- d,o44.�1- — 4070
ontractor's Name �// Mailing Address Telephone No. (include area code)
:•'•'• »ii Lot Area
of ea
RODE• OCATIOE>!!:''` Sq. ft_ 1/4, 1/4, Section , T N, R E (or) W
Building "loss ® i � ' Subdivision Name /�� /' L Lot No_� Block No.
Zoning District(s) d9'• Zoning Permit No. `7 / /'_� /(//`,�O'` /( / Front Rea •G`f � " Left ✓� Right
l2 - 1 Setbacks 30
etbacks f � 3 f ft. f
iiiF �
::::: i s ti i: ::ii:::: i •::: : :: .
:.:. �j, :::: �j,'. :iiS Y :..ip.::: : : : :�+ ': :? .,� . ' yyy.���. : ,. :::::::: ::::::::::'i::::i::i::ii:::ii; i:'rj;:i:::i.
: : .. ::::::::: ..:.:...... k.. .d,� .{� . ::. .... ... .�r...�.�aC. ... ::::: : :r:: il�:t� .'. . A . � l:i: �:•.,, � .::•• .i:b: }: ^i:}:•; {• :+ : :}::i
New ❑ Repair • ingle Family Entrance Panel . i, orced Air Furnace fuel Nat. L. P. Oil Elec. Solid Solar
l Alteration ❑ Raze • wo Family Size: f Q:p amp • • adiant Baseboard or Panel Gas *
❑ Addition ❑ Move ❑ Garage ServiEe: ❑ Heat Pump Space Htg X ❑ ❑ ❑ ❑ ❑
❑ Other (print): under ❑ Boiler
O verhead ❑ Central Air Conditioning Water Htg K ❑ ❑ ❑ ❑ ❑
❑ Other 0 Other *0 Dwelling unit will have 3 kilowatt or
'''''``'' ` "` "'' more installed electric space heating equip.
Site Constructed Concrete P g .
q P
. !!1000104 � >< €'• »` >i : ::' €` ? <'' ?: >i''. Infiltration control option i : F
,..;;; ❑ Manufactured Masonry • op o s ❑ Full sealing
I: :: � of joints. ❑Blower door test. ❑Exterior
. A���i�`��> >s >::: >::» T
❑ reated Wood Sewer
::: >••;•• :•::•:•;;:;•:•;;;::. Other air infiltration barrier.
nfi >. >: ;..:0.,11.0.... M • ter ��1Vlunicipal
U Wished Basement q. ft. Se tic HEAT OSS<' Uta . »>`.>:'>
>::Sx
❑ 1 -Story > > ?s » » » ? >':'• Permit No.
Living Area 1 i9 Pv Sq. ft. gSQ -Stor Envelope �J �d /� BTU /HR
3Q -Story ❑Seasonal
'11. WATT » »'. » E` > #> #'` # >'':.`: >i >ii� >> f
Infiltration / .
Garage S ft. ❑ Otherermanent :::::::::: / 74, 7 7 BTU /HR
g q Munici al Utility P
:.::.....:....:.:... .:::::......................:..
❑ Plus Basement ❑ Private On -Site Well $ / VO nDO, L a
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 Dep rtment or municipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE — DATE SIGNED
revoc
APPROVAL CONDITIONS i s permit ation of is issu prur ntto other the penalty. following conditions. Failure to comply may result in suspension or
•
is permit or
Town
Village
it
❑ C Count
❑ State of: 9 ❑ e o Municipality N m
Y Y ❑ u ber of Dwellin Location:
II�� �
P Y
€< ISDICTION:i cacti.. O - Z./ (0 6
:::::::::::: .::::.::.::::.::::»::>::::::::>::>:::::»>::::>:::::::. :.::.:.:.::::: >:::::::::: >: .
1� :;::::;::iii .. y::; ,.�w� �
Plan Review $ 4'0 .t) 0 Construction D t -
Inspection $ VAC Name ( / d � V.I.A ��.-'
Wis. Permit Seal $ 30 0 0 ❑ Electrical 1 Z 4 f � �
Other $ ❑ Plumbing Date S 1 c..3
'XE rosion .3—S.—Kb
Total $ ...7 r 8 . e O Cert. No.
SBD -5823 (R. 07/92) WHITE - Issuing Jurisdiction YELLOW - DILHR GREEN - Inspector PINK - Owner /Agent
S Z ail.4 e htt i•td sed:8/89
ZONING /LANG USE COMPLIANCE CHECKLIST
•JOB LOCATION: / //S 1A- ZONING: k /
PROPER OWNE' 'CONTRACTOR: 9- je�G �(,ezzy
/NEW
CONSTRUCTION DATA: t CON5TTRUCTI{N ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
/.I/► - - . S 3 L. -
•
COMPLIANCE CHECKLIST (Check only those applicable) •
COM .IES DEFICIENT DEFICIENCY /COMMENTS
_ Use
_ Lot Width
Lot Area
_ Floodplain
_ Front Yard
_ Side Street (front 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: C-
The Director of Community Development, orkesignEze, 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) Required
REVIEWED BY: OATS: 4-4;;I:
GATE
NAME 9,,e /y„ .# ADDRESS
LOT 5 - 6 BLOCK WARD
SUED 1 V . ?,Gt.re ltd-d ZONE
STREET NO. f
//� �ar.cc '7 -- LOT DIMENSIONS
SIDEWALK EXISTING YES 0 NO [
BUILDING GRADE ELEVATIONS STAKES SET AT SITE �2.� � c;?. ,I9 9'Z BY &
FEE; $15.00
i� 4
DEPARTMENT OF PUBLIC WCRKS
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
00T 7G
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address //
Owner's Name /
Name of Subdivision 2,,—' al, its -cam
Lot # �(o Bldg. Permit # 3L,4/,7
No. of Units
Fee Required / 0 O 0 0
Fee Paid ,E)0.00
Owner's signature (y_)047, Date
Inspector's signature /11144-4(41(1-1.-;
Date S*
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
7 3 /ett
ti 5
6-a fi2J
. qt6P-i
„4, 5-,