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Home My WebLink About0022566-Building CITY OF OSHKOSH N°_ 22566 PERMIT - APPLICATION AND RECORD TYPE: BLDG jg HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING te--/ FLOOD PLAIN HEIGHT ADDRESS a S//e- A _ PLAN NO. G ✓Z OWNER of'` ° 4 Z 4 DESIGNER USE /NATURE OF WORK 5� ,d fie / • BUILDING CONTRACTOR .��AL/A. ' < r 4 - L, _r'_ GI - SL Size ar Sq. Ft. 11 b' # Rooms 21 " # Stories Height ZZ Foundation ed-� Class of Const. P" Occupancy Permit HEATING CONTRACTOR !!.."--re- Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR L:1s.-ytt. 2 Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR - 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 4 ') De ( • 0 a Permit Fee Paid $ /30I 00 Park Dedication $ Me • ISSUED BY /� • Date 3 / / /?i Final /O.P. 5 / 2°1 f ' 1 In the performance of this work I agree to perform all work pursuant to rules governing the described construction. / SIGNATURE 4l 1 ' al • 1 / or AGENT /OWNER D , E ADDRESS K..5 r' a 3 rd 3,5 TELEPHONE # Z i / State of Wisconsin Department of industry, WISCONSIN UNIFORM / Labor 8 Human Relations BUILDING PERMIT APPLICATION N .3 _O' Division of safety 8 Buildings Madison, WI 53707 APPLICATION Wisconsin Statutes 101. 63, 101.73 See Instructions on back of pink copy) PARCEL NO. PER. T ; ; R l E T < < € < ' < € <<<< E PLUMBING TRU TUBE HVAC El EL EC ❑ S C ❑ 0 ;;;;;;;: r's Name Mailing Address Telephone /V / / / 3 ® ,a/a/( �E 5 / Z3 s= 803 S � Contract s Name Mai g Address Telephone ....................................................:..:......................... ............................... ................................................................................. ............................... ................................................................................. ............................... ................................................................................. ............................... ................................................................................. ............................... ................................................................................. ............................... T N R E or /4 /a SECTION W ( ) Building Address „ n , Subdivi ion Name . Lot No. Block No. 2 /D e r I/ 5,o-a- I Zoning District Lot Area Front i Rear , i f Left (). Right f / sq• ft. Setbacks S ft. T _ ft. d ft. ft. a:: .fl:: IR: . .9 I.. . . . . .. .. . . ............... h.. . ... . . ..................... New ❑ Addition Raze M Single Family Entranc��rwl Forced Air Furnace Fuel Gas • '❑ ❑ Nat. L.P. Oil EIec.SolidSolar Alteration ❑ Repair ❑ Move Two family Size: amp g Radiant Baseboard or Panel ❑ Other S rvice: ❑ Heat Pump sPace fig. tgf ❑ ❑ ❑ ❑ ❑ ❑Other MUnderground Boiler WaterHtg. ❑ ❑ ❑ ❑ ❑ ❑ Overhead Central Air Conditioning ff.. 000k L, o l Ati :::<: Other Dwelling unit will have 3 kilowatt or .... .... ... ............................., more installed electric space heating equip. ,off C 1 PLUMBIN j Infiltration control option is ❑Full sealing ❑ Attached ❑ Detached Site constructed < ; : ❑ Manufactured ❑ Masonry Sewer Municipal of joints. ❑ Blower door test. ❑ Exterior i i??:.ARA! > : >:: > » > ❑ Treated Wood air infiltration barrier. > :. ;:.; >... _.::a ::.: '� " ❑ Other Septic �AT::. }> Basements Z Sq. ft. 3 »; T IF ? >:: >:::<:: Permit No. d Z23 ❑ 1-Story s >» >a » >s Envelope BTU /HR Living Area q ❑ 2 -Story ❑ Seasonal > 1. WA «::<: >: <: :<: ; <:::<: >::<: >: >> : <: Infiltration /4 3S S BTU /HR 6 / ❑ Ot r Permanent he IYMunici al Utility :I T :B II f : .4 ' >: Garage Sq. ft. P ❑ Other ❑ Private on -site Well $ 7e, 2®e, do The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Municipal Ordinances and with the conditions of this permit; understands that the issuance of the permit creates no legal liability, express or implied, on ' epartment or Municipality; and certifies that all the above information is accurate. / SIGNATURE OF APPLICANT /A %.. 4. DATE CONDITIONS OF APPROVAL This perm, ssue m pursuant to the following conditions. Failure to compl may result in suspension or ' revocation of this perm or oth penalty. /t/s/ e �/.0� z) C6 1 �- & f t / eel ../.4 —4 iz-blica3 ,/ c'te..) cAd.:)-7= j= A 4.. a /1.4.4, ,...0 ,,,,.4.e.c a` Z3. /S I, Cie....t..e--rice of - 1 TOWN Municipality Number of Municipality Number of Dwelling :: ❑ O 0 CITY 0 P tY P tY 9 ❑ STATE ❑ INDEPENDENT Inspection Authority / Location, if different URIS T I!1:::: y > l t- 7 U _ (o . . . . . . . . .... . . . . . . . . . . . . . . ....... ......... . . . ...: : (p OF: OGZ — — — — — — ::; : : ::P Ali.:. • .............. Plan Review $ T, 00 cm Construction P21.4( ❑ HVAC NAME 2 / it f1./..v Z�-' Inspection . . . . $ ❑ Electrical U ° p / / % 30 Wis. PermitSeal(s) $ " ❑ / S O Plumbing DATE Other $ ❑ Other TOTAL . . . $ 7 , O O CERT. NO. 42 S— SD SBD 5823 (R. 4/89) WHITE — Issuing Jurisdiction YELLOW— DILHR GREEN — Inspector PINK —Owner /Agent Revised: 8/89 ZONING /LAND USE COMPLIANCE CHECKLIST JOB LOCATION: c 9 4 ,00 A 44 / ZONING: PROPERTY OWNER /CONTRACTOR: f. /a€Ge/ CONSTRUCTION DATA: NEW CONSTRUCTION ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.) y/p i.,1 4 Gf 4 S 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 REVIEW AUTHORITY: y fr7 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. 1 - /// APPROVED DENIED Plan Commission Action Required Variances) Required r � REVIEWED BY: 4 I' / DATE: c3 City of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address 0 2 Li /0 AzAzd il: Owner's Name / I/ //, 4.21 1A1 Name of Subdivision Lot # / Bldg. Permit # 2 - 2 -C 64 No. of Units / Fee Required /8-0. e-0 Fee Paid / . 4 - 0 Owner's signatu - , Al!...._. Date 1/ alw Inspector's signature Date 3 4 9 / Parks Subdivision Improvement Accts. Rec.: 362 -041 DATE ' (53 -9/ NAME C V'' N L°c- L ADDRESS LOT BLOCK WARD S UBD I V. �W- r t f ZONE STREET NO. 'FWD ket t..t_ SQ LOT DIMENSIONS SIDEWALK EXISTING YES LJ NO E] BUILDING GRADE ELEVATIONS STAKES SET AT SITE 3' S , 19 q l BY L' k.► FEE: $L0 ray DEPARTMENT OF PUBLIC WORKS I, the undersigned, owner or agent of the above described property agree to have the grade estabiished before excavation has commenc =d. Ajar. 16. 004294 t 5 - -- - - - _.._ , __ _._.._ ._ -._ _____- ..__., / = /� , ---. N ci -# /ov a c-c j C sy ' > c6 a y 7 4 NJ ,1■ % 4 I I a ‘ In + I b'S4. ' ,1 6 1 \p n • c v) CN c . v '‘T'0-;?/— I 4 1 , " •A-2°----.- 1 / /0 - 0 o ./'474 '