HomeMy WebLinkAbout0023082-Building 46) . CITY OF OSHKOSH N° 23082
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PERMIT APPLICATION AND RECORD
TYPE: BLDG NI HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING I C-- FLOOD PLAIN HEIGHT
ADDRESS / /too Xi--gr-r-t- ... i. - PLAN NO.6
OWNER eGIAZi/J' ig27c-
DESIGNER
USE /NATURE OF WORK ),,<) / ` 2 A-_
BUILDING CONTRACTOR /
Size Sq. Ft. 2.0 9 3 # Rooms / a # Stories a Height
Foundation ��O"!4— Class of Const. P Occupancy Permit
HEATING CONTRACTOR L�0 41/111 ./ (1.,41/(.46/-
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR e tefeb - 77 ,14t
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR __//4;e
BT _ WH Disp WSoft CBasin
_Lay _ Sh _ DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation to 6 0A0 00 Permit Fee Paid $ / 9" S Park Dedication onn $ �
ISSUED BY Date � / '5/ /91 Final /O.P. / — a ?/
In the performanc of this work I - • • ter all work pursuant to rules governing the described construction.
SIGNATURE URCIIII i+ kill
AGENT /OWNER DATE
ADDRESS , XJ 0 \ 1 \V c—iNcl.. \ ` '‘D.-6 \
TELEPHONE #
67 SG /32,a 9/
State of Wisconsin W ISCONSIN UNIFORM
Department of Industry, p
Labor & Human Relations BUILDING PERMIT APPLICATION NO. 2 3oc 2
Division of Safety 8 Buildings
Madison, WI 53707 APPLICATION
Wisconsin Statutes 101.63, 101.73 ($ee Instructions on back of pink copy) PARCEL NO.
.... . .... .... ... ............. ... . .......
: : : : : ..... ::::: ...............................
PERMIT P Q E <
"IONSTRUCTION 111 HVAC ❑ ELEC ❑ PLUMBING ❑ OTHER:
O <:s: .: ::
e r'sNa; >: » >:: > Mailing ss Telephone
S ._ h € 42 ._ "1 73
Contractor's Name Mailing Address Telephone
:'PROJECT >::::; >::: >::<:::;::>
>:<:<:: Lot Area
S . ft. �/. '/a SECTION T N, R E or W
Sq. ( )
Building f j Address � S o �� Lot No. _ Block No.
// l0l ♦ La e- - ,' e T �'A 6 � r"'st,• �( �:�'
Zoning istrrict(s) Zo ing Permit No. Front Rear Left Righ
`` j \ Setbacks .2 `s ft. ( ' 7� ft. . _ ..... - - - r ft. ...... ... ft.
Occ .. . «.: EL :: 9 . ..: :
ew ❑ Repair ngle Family Entrance Panel "Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
I teration ❑ Raze ❑ Two family Size: Z'O amp ❑ Radiant Baseboard or Panel s *
❑Addition ❑ Move ❑ Garage e�pice: ❑ Heat Pump Space mg• ❑ ❑ El ❑ ❑
❑ Other ..G9JJnderground ❑ Boiler Water Htg. ❑ ❑ ❑ ❑ ❑
❑ Overhead ❑ Central Air Conditioning
❑ Other * ❑ Dwelli g unit will have 3 kilowatt or
❑Other '< : , more instal d electric space heating equip.
its constructs oncrete :.10 PL UM6W4. � :;:; .: ; :;;;:: . ; > Infiltration control option is ❑ Full sealing
dsonry 4,0v
r of joints. ❑ Blower door test. ❑ Exterior
❑ Treated W Muncpa M ' �"�'`''''' ''''''''' anufactured I air infiltration barner.
ii
❑ Other Septic :13.: AT..OSS... Ca_{cftlatet# .
Unfinished Basement Sq. ft. ' Permit No. T7 BTU /HR
.�,,p ❑ 1- tory !8 .
,.S < = -- Envelope
Living Area a`O 3 Sq. ft 7
Story � ❑ axonal 1 :' AT>E f : Infiltration D 7 BTU /HR
Garage 4OJ sq. ft. ❑ Other .m . •ermanent Municipal Utility 14 .: ILA COST
❑ Other
❑ Private on -site Well O —r000
❑ Plus basement $
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 impli : • , on the Depart i _ i or Municipality; and certifies that all the above information is accurate.
SIGNATURE OF APPLICAN - \ .` ` _ DATE L"1 \ c\
CONDITIONS OF APPROVAL This permit is issu = ;W : nt to the following conditions. Failure to comply may result in suspension or
revocation of this permi o • her penalty.
❑ TOWN ❑ VILLAGE CITY ❑ COUNTY Municipality Number of Municipality Number of Dwelling
U :..._. : ....:::.:::: ❑STATE IN EP NDENT Inspection Authority Location, if different
J URISDICTION //
• $' PE ill I U ORM IP'�If AlttT p } I 8Y
Plan Review $ .x Construction / _ f
❑ HVAC NAME � i.f ti - -�- - _ �� 4 / Inspection . • . . $ ❑ Electrical9/ � 0 �/ i it Seal, , $ 30 . c O ❑ Plumbing DATE / ' S ? `
Other $ ❑ Other e s S•— 0
TOTAL . . . $ J CERT. NO.
SBD 5823 (R. 8/90) WHITE — Issuing Jurisdiction YELLOW — DILHR GREEN — Inspector PINK — Owner/Agent
/00 000
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION:
i ZONING:
PROPERTY OWNER/ •' RAC 1
CONSTRUCTION DATA: NEW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, 0'1, sign, deck, etc.) o
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES 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
R:VIEW AUTHORITY:
The Director of Community Development, or d signee, ust 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.
L- APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: „ _ j /�" DATE: 5-
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