HomeMy WebLinkAbout0020187-Building (1111Dor CITY OF OSHKOSH N° 20187
— PERMIT APPLICATION AND RECORD
TYPE: BLDG* HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING / ` FLOOD PLAIN HEIGHT 2 ?'
ADDRESS / / 3 o -41-76 - PLAN NO./ 736 ge'<-
- -_ : . ;...,,t /
OWNER A
DESIGNER
USE /NATURE OF WORK 5/2(.17 i rfI,f a(
BUILDING CONTRACTOR g-F-
Size /267 Sq. Ft. / 7(0((i!/ # Rooms 14 /JiZ # Stories _ Height 7s
Foundation Class of Const. O Occupancy Permit/a
HEATING CONTRACTOR ( 14?1J
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 7(./a —�'
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 $ Vo,ODO. 00 Permit Fee Paid $ /301 O 0 $ Park Dedication $ 4 d -- e l •
ISSUED BY i Date , CY? " /9 Final /O.P. /� /" /
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR' , Air 40--.e..ouiv 1 • , -C-/---e-AcZl•------ % /0
AGENT /OWNEERR DAT
ADDRESS /11/L_D ----r `-'4 , -.3 ' s j6
TELEPHONE #
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: //3o d ,t/ �s- l ZONING: ki
D•
PROPERTY OWNER /CONTRACTOR: ✓1 lam' = Al i
CONSTRUCTION DATA: V NEW CONSTRUCTION ADDITION ALTERATION PAR ING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
/
COMPLIANCE CHECKLIST (Check only those applicable)
COWLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain '
Front Yard
Side Street (frcrtt yard)
Rear Yard
Side Yard (R)
Side Yard (L)
.
Parking Spaces
---4--- Building Area
-- Lot Area Per Family
- — Corner Lot
h Landscaping
Transitional Yard
Off - Street Loading
Vision Clearance
Height
� / W &AA,/ REVI AUTHOR
The Director of Community Development, or designee, 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) Require' ,
e ,,
REVIEWED BY: /�� `,� �„„ _ DATE:(1 ll
P 7/34, eF90
State of Department ofIndustry, WISCONSIN UNIFORM
Labor Human Relations
Division n of Safety &Buildings
BUILDING PERMIT APPLICATION NO. ?°J 87
Box 7969 WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 See Instructions on back of Pink copy) PARCEL NO.
STRUCTURE R
U E
HVAC
ELEC
PLUMBING
El U
Owner's Name Mailing Address Telephone
Con cto 's Name Mailin Address Telephone
,o // 3 - 34 -k3S
t3ATIOW
/• SECTION
. T N R
E (or)W
Building Address Subdivisio ame y Lot No Block No.
� / /3d �� / / 4 1 2-'s
Zoning District L6t Area Front Rear Left Right
Sq. ft. Setbacks ft. _ ft. ft. ft.
::1 PRO E ; :: < : >: »:::;<;;:>::::,:« < :; ,
;;:: «<T:;.. «::«« ::: : : : :..: .
' .:::::::::::::::::::. �:... TY# �>": ::: �...:.EI.I�'I�#�!ii�.::: �i�`;AC::� :. .:> ;. >:> ;«««:
il New ❑Addition ❑Raze I yeq� Single Family Entrance Panel Two Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
Alteration ❑ Repair ❑ Move LJ Two family Size: AOC/ amp 0 Radiant Baseboard or Panel Gas *
❑ Other ervice: ❑ Heat Pump Space Htg. tgl ❑ ❑ ❑ ❑ ❑
❑ Other Underground ❑ Boiler Water Htg. N' ❑ ❑ ❑ ❑ ❑
Overhead ❑ Central Air Conditioning
tb,: * Dwelling unit will have a kilowatt or
� ? <['< >«« <' '? ..: ;: > :::. : ; >«;:.: < ` . ... :«: ❑Oth
.. more installed electric space heating equip.
Site constructed Concrete 0.:> P ; 0 :: > > Infiltration control option is: ❑ F ull sealing
Attached ❑ Detached fi p g
: Man ufactured Masonry wer of joints. ❑ Blower door test. ❑ Exterior
2: .
❑ Treated Wood � Municipal air infiltration barrier.
>: <:<:: ❑Other ; :: :::::«::..
Basements 5 / Sq. ft. t i."::'ST IF : > ::<::«: 0 :::::»A ::LOSS {GalcuIati }:::«:<> ::
r� ft,;! :::: . .........::....:........... Permit No. ,,/
10 7' ❑ 1 -Story <:U s >> >> Envelope s 2. 4 : 40 BTU /HR
Living Area / Sq. ft.
❑ 2 -Story ❑ Seasonal 1' WATE » > » » _ <::<: S
Garage 5 v .
S ft Othe Permanen �� Infiltration � 7S4 BTU /HR
4U,t b Other
Municipal Utility *<IRR:C$T < > >>
Private on site Well $ 7�,aOt Q D
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Municipal Ordinances and with the conditio ns of this permit; understands
that the issuance of the permit creates no legal I ity, express or implied, on t . Department or Municipality; and certifies that all the above information is
accurate. / SIGNATURE OFAPPLICA / ��..w. ., ,i , c _ _ DATE � /c7()
CONDITIONS OF APPROVAL This permit is i sued pursuant to the following conditions. Failure to comply may result in suspension or
,/ revocation of this permit or other penalty.
)7
,723, of 0)Ccc) , 4ftic - Y177.t-Ctze....e /,,trz.„
: ❑ OWN
❑ VILLAGE Municipality N CITY 0 Munici ali Number of Munici ali umber of Dwelling
' .. T _ ❑ STATE ❑ N EPENDENT Inspection Authority Location, if different
R.N [<
ff
... ...
Plan Review $ Tk/ • Construction
HVAC n NAME T ief iA otd..c�l��
Inspection . . . . $ ❑ Electrical �/i9�1
Wis. Permit Seal(s) $ ` 0 °, ❑ Plumbing a DATE l
Other $ I Other
TOTAL $ CERT.NO. a SS ~ v
SBD 5823 (R. 4/89) (` - . 0 t RITE Issuing Jurisdiction YELLOW - DILHR GREEN - Inspector PINK - Owner /Agent
DATE d/q U
NAME C/L ADDRESS
LOT ("7 BLOCK WARD 7 - 1
"" �UBDI n .( L# /
STREET NO. //30 ✓ i.4--n t.., LOT DIMENSIONS .
SIDEWALK EXISTING YES El NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE (27_ �$. ,19 qQ BY
FEE: $ .00
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
i-Y : 0-1-4-2----_
x 775 G
r
475/6'5
City of Oshkosh 1/1/25
PARKLAND DEDICATION FEE COLLECTION RECORD
Address 1/3D 4 DAir
Owners Name / A,,
Name of Subdivision &tea /roseti/7"'
Lot # Z Bldg. Permit # :2-O/
No. of Units
Fee Requi red /D0 OD
Fee Paid
� r
f
Owner's signature , �;;,"
e // a I qO
Isr
Inspector's signature � Date A-0.0
Parks Subdivision
Improvement
Accts. Rec.: 362 -041