HomeMy WebLinkAbout0001218-Building CITY OF OSHKOSH N o 0121
PERMIT — APPLICATION AND RECORD
TYPE. BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN OCT HEIGHT- --
ADDRESS 4 : 25 4-5 - PLAN NO. e4 r S 3 F8 2
OWNER 6A6E2r - d .4 eONSr l.0 770&) 02700 1457-mere./YJ
DESIGNER t /cK. LC. m
USE /NATURE OF WORK I"G'' v//- G-- 444 y
,447: 4. Gc9/A /.v f/lo vr- &-t fZoo,i lof
A#' 50M (w r 414 O9 .6 •
,Lor _ 64 /,D _ ► S • ,,t.) 2s
BUILDING CONTRACTOR 0
Size 2 - 4 : 1 1;4j 2 Sq. Ft. / # Rooms5 /0/1" /-s # Stories / Height /„--/
Foundation vv
dat on `�"���• Class of Const. A- ti Occupancy Permit 1C
HEATING CONTRACTOR /1 AI¢4?.vt 5 /A -
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR a:A- " 1 •
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR Z-O/4-'rrVe 5
- 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 $ �ZS Dvp Permit Fee Paid $ • p� Park Dedication / °e2
ISSUED BY 9 ' Date "'O p - o Final /O.P. / 3 B - 3' 4 '
In the performance of this • agree o perform all work pursuant to rules governing the described construction.
SIGNATURE �i. / i
B EN c - DATE
ADDRESS
TELEPHONE #
State of e nt of In WISCONSIN UNIFORM (.ice- /�cr
Department of Industry,
Labor & Human. Relations
Division of Safety & Buildings BUILDING PERMIT
Box 7969 APPLICATION NO.
�'
Madison, WI 53707 APPLICATION SS —a�--
Wisconsin Statutes 101.63, 101.73 (See I nstruction on back) PARCEL NO.
PERMIT REQUESTED
ATRUCTURE VAC XELEC ❑PLUMBING
Owner's Name 644/5 Mailing Addrss /// elephone
�3 f " ,USc� 7 U c97e , �7 r 1 Ge�-
Contractor's Name Mailing Address Telephone
LE'CA ,
y N Y., SECTION , T N, R, E(or)W
Build Addr ess �N� Su vision Name
qq �� / Lot No Block No.
2546 t /�i,USG#/ /4c ,, ,- - /- - r*cv `7---
Zoning, District Lot Area
e41
Front Rear J� Left Right
�Z Sq. ft. Setbacks ft. / ft. ' /6l. -5- ft, 1S ft.
la. PROJECT 3. TYPE 6. ELECTRICAL 9. HVAC EQUIPMENT 12. ENERGY SOURCE
lew ❑Addition ❑Raze Single Family Entrance Panel Forced Air Furnace Fuel Space Htp. Water Htq.
((]]Alteration ❑Repair ❑Move Two Family Size: �/2 amp XRadiant Baseboard or Panel LP Gas ❑ ❑
❑Other ❑Other a e: 0 Heat Pump Nat. Gas
Underground ❑ Boiler Fuel Oil 0 / LJ
verhead ❑Central Air Conditioning Electric ❑ ❑
1b. GARAGE 4.CONST.TYPE ❑Ot Wood ❑ ❑
LbAttached ❑ Detached Site constructed Concrete 10. PLUMBING Solar ❑ ❑
Manufactured Masonry Coal ❑ ❑
2. AREA ❑Treated Wood Municipal Other
ewer
/ ❑ O ther
Basements / /�lr Sq ft 5 STORIES Septic 13, HEAT LOSS {Calculated}
/ j � f f' Permit No. p l�
/ / Y 1 -Story 8. USE Envelope . X BTU /HR
Living Area / Y Sq. ft. 2 -Story easonal 11. WATER — " Infiltration/ , 777 BTU /HR
❑Other permanent
Garage Sq. ft. ❑Other ❑ Private -on -site Well 14. ESTIMATED COST
7 Olunicipal Utility $
The applicant agrees to comply with the Wisconsin Unif I ng e•de . • -r uncipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legal liabl ' • ••• ess or pli: • • the partment or Municipality; and certifies that all the above information is
accurate. 7
SIGNATURE OF APPLICANT�C 1.1, � ee-, DATE
CONDITIONS OF APPROVAL This permit is issu- • pursuant to the following conditions. Failure to comply may result in suspension or revoca-
tion of this permit or other penalty.
4
■'‘-' / j r— , 7 11 -/ / , -.,r / $ / /-5/e Fi4
71/4 f_./i -r 4i 4. /L ` - e v �J
,� / r tom- /Q2.. L.1 Ll --de ,2 .. 4 .. 0
i t s ' - .' ' /2 cc L)
❑TOWN ❑VILLAGE ICITY ❑COUNTY Municipality Number Municipality Number of Dwelling
C DSTAT - ❑INDEPENDE=NT Location, if different
FEES: I l'I'l;Sl ':WIS. UNIFORM Oil f U44 1 RMlT l tlEE' BY:
ISSUED SEAL, N0.
Plan Review $ E onstruction
iri VAC NAM
Inspection $ E
Electrical t((J//
Wis. Permit Seal(s) ... $ 3 ❑Plumbing DATE
Other $ ❑Other
TOTAL $ 43, g46. CERT. NO. a% /
e
\
DILHRSBD 5823 (R. 11/84) WHITE — Issuing Jurisdiction YELLOW — DILHR GREEN — Inspector PINK — Owner /Agent
ZONZrc/L ;ND USE C MPLIANCE C[•>EQQ IST
1. GENERAL -_. _. .
•• Building Permit # Zoning IQ 1io Contemning Non- Conforming
Job Location N- Lot Dimension
Property Owner (P€rfj -> .4SGt - Ipt .
II. • CCNSTRIX ICN DATA - - - -
• Describe Work: 5 tom --. -
NEW CCNSTRUCIION ADDITION- + ' ALTEiATICN
Accessory •
Building *gig Pool • Z61.11114* Family -
Fence Deck/Patio Sao - Family.
_... Boathouse . Sign Milti=Family
Otility Structure Porch ' Y.; a i
_ Other (specify) Maiiiifacturing
III. CLIANCE CHEM
CcaMlies Deficient Deficiency /Ca nts
1 Use
____ Lot Width
Lot Area
Floodplain _
• Front Yard
Pear Yard
T T Side Yard (R)
J Side Yard (L)
- Parking
Building Area
—
It Area per Family
— . Cornet Iot
____ Other (specify) .
IV. REVIEW AUMORITY
The Planning Director, or appropriate designee, rust approve all plans, except
the following: (1) Alterations or interior work when the use is conforming and
when no change of use is proposed. (2) Maintenance items, e;g.; siding* wiz
etc., when the use is conforming and when no change of,vse is proposed;.
Instances
we work complies with the above criteria, ttie. p�ui t Cq
m n. use reviewed
by the Building without referral to the P
I7pector
larunisug D3rector:
APPROVED NOT APPROVED
Plan Connission Action Required .
Variance (s) Reauired
REVIZEWZD BY: i G. P6sActvtAfkmt RAls: q-t lit
031 DATE a ^ 0
NAME a4 2 A6 /--- ADDRESS ,7D 6 /2/
LOT 7 B LOCK WARD 7_,__________—
SUEDIV./ �4if /D 656,4. .,‘..4
ONE
STREET NO. a�" "-=' OT DIMENSIONS
SIDEWALK EXISTING /-41/24/A A YES LJ NO EJ
BUILDING GRADE ELEVATIONS STAKES SET AT SITE C I– e , 1 9 SC BY \'
FEE: $10.00 p .(:, � &6
DEPARTMENT OF PUBLIC WORKS
1, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
3.37
/.--
• S te"
\�'\ City of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address .;25 / NEB (/,4 , 51
Owner's Name e E/1 -1= /2f/ScA4 , ,* - , „pT
Name of Subdivision /fUSCA<— 1 r /§.-'-
Lot # i Bldg. Permit #
No. of Units
Fee Required '/ a v
Fee Paid 1/ac
Owner's si gnc ture I, / i Date - -
7 9--------
Inspector's sign.. u Date
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
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