HomeMy WebLinkAbout027598-Building ® - s CITY OF OSHKOSH N°_ 27598
PERMIT — APPLICATION AND RECORD
'TYPE: BLDG Ar HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS c 2-1 7 4 / 6— 1--A-ex-i. PLAN NO., t / 7 0 3 92-&-
OWNER , • /'✓ St�
DESIGNER ff��, P p�
USE /NATURE OF WORK h. CG 1 X a • 9Y,u .
BUILDING CONTRACTOR — _ _ ____ ,
Size /� Sq. Ft. / S / # Rooms 7 -3 81-713 # Stories Z Height .2 la
(
Foundation dam Class of Const. k Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR ,60i.e.A.) Electric Serv. New 111 Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR It 2Z.? 2A42/
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 $ 4 000 0 0 Permit Fee Paid $ PI 1 O ✓ Park Dedication $ /0 0
ISSUED BY GDate 3//0/4 z., Final /O.P. / `°Z/? •
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR' .' ialail ill t , _ / J /3
GENT /OWNER �� , E
ADDRESS Of �� : / ..,. 2�' ' .4 3 .� -- f5 ∎ ------
TELEPHONE #
State of Wisconsin
i ¥ 27 D 9 2- i2
Department of Industry, WISCONSIN UNIFORM
Labor &Human Relations BUILDING PERMIT APPLICATION NO. .2 7S p i'
Division of Safety & Buildings
Box Madison, Mad n, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
PERMIT REOUES'TEO ^ CONSTRUCTION 111 HVAC ❑ ELEC ❑ PLUMBING ❑ OTHER:
Owner's Name Mailing Address Telephone
Contractor's Nagle Mailing Address Telephone
,f?s e 4e€4/A.- ///3 2, a 3 s —cfo3S
Lot Area
:: LOC*:T OR :.:
Sq. ft. '' /a, '' /., SECTION , T N, R E (or)W
Building Address ,J Subdivision Name Lot No. Block No.
a f
`, - lit- ZoLsc..-"v fi ,:cietirt. ed.. ..aii /9
Zoning District(s) Zoning Permit No. Front Rear r( Left Right
le t Setbacks c9 r I y
ft. Sb 3 l /z, n. ft. q n.
S. :;Oci a .: 5 ELF. AL :: :SR::.#:IV.AC:EQU1PMEW1 1.2. >'ENE RGYSOURCE !
' New ❑ Repair gr Single Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
*
Alteration ❑ Raze Two family Size: OO amp Radiant Baseboard or Panel Gas
❑ Addition ❑ Move ❑ Garage Service: ❑ Heat Pump Space Itg• ❑ ❑ ❑ ❑ ❑
❑ Other !NI Underground ❑ Boiler Water Htg., ❑ ❑ ❑ ❑ ❑
❑ Overhead ❑ Central Air Conditioning
0 Other ': ! € . l ;1 E ! E T tL ND1k `IO-. ❑ Other * ❑ Dwelling unit will have 3 kilowatt or
.
more installed electric space heating equip.
Sit Concree 10 PLUMBING ; % : : :: :M ''! ; r Infiltration control option is: ['Full sealing
.. .. _ e constructed t
� — P
. >AI•AE > Manufactured Masonry Sewer of joints. El Blower door test. ❑ Exterior
❑ Treated Wood Municipal air infiltration barrier.
Unfinished Basement i i 73 Sq. n. S''ATORIES ` ❑ Other Septic p 1�« >I�A'�':I,.OSS �Oalctslatect)
... .. Permit No. i
/j%/ ❑ 1- Story_ ><> < »> Envelope L • 3 32 S •4 kBTU /HR
Living Area /0 W / Sq. ft.
2-
Sto
Seasonal �� :::: ...<<<< > >< >«< ><<< » > ><< > > >< Z
�7 i'Y ❑ 1i�`AY� ....... Infiltration � 2 ( PO r Sr BTU /HR
Garage S/ 4O S ft. Other .Permanent E( Municipal Utility 14 EST l3UI DI COS '
❑ Other
Private on -site Well
❑ Plus basement _ $ i'O, OOO % O 0
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, o the Department or unicipa • • • and certifies that all the above information is accurate.
SIGNATURE OF APPLICANT ,Me - A • L DATE
CONDITIONS OF APPROVAL This permit is i ed pursuant top the following conditions. Failure to comply may result in suspension or
revo c a tion o f th 1. p o other penalty
TOWN ❑ Munici
❑ VILLAGE CITY 0 Municipality Number of Municipality Number of Dwelling
P tY p y e
li,..1 W1•4 peet--
1:: ❑ STATE ❑ IND ENDE Inspection Authority Location, if different
R18DTN ;; /
OF �Q i_2 ------
ii PERM : �. 10ftE. I irgif I S R .....
. E . : : : [L. a# ' 1S$t1E� #iY
:
Plan Review . . . $ 4 .c Construction R
()
HVAC NAME
Inspection . . . . $ ❑ Electrical 3 Z 27/444
Wis. Permit Seal. , $ 30.0 O ❑plumbing DATE 3 /(0/9 Z
Other $ ❑ Other
TOTAL . • . $ 70 .00 CERT. NO. J
SBD 5823 (R. 8/90) , WHITE — Issuing Jurisdiction YELLOW — DILHR GREEN — Inspector PINK — Owner /Agent
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: ,;) 04-ie' /9 ZONING: `'/
PROPERTY OWNER /CONTRACTOR: / 41.N. ,12,ta -
CONSTRUCTION DATA: /NEW CONSTRUCT:DI ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
17®,/.(J ( 1Z Q j10( . 2Yuz 5 76 A
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
.■\ Use
Lot Width
Lot Area
Floodplain
_ Front Yard
Side Street (frait 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: t./ lj�jl
The Director of Community Development, or esigne , 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.
` - APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: '. -' DATE: `v
DATE 3/0/7 2�
NAME ,d. f c/ . L J% 2't ADDRESS
LOT / f BLOCK WARD A ?'
S UBD I `,/ .
jzitc,r ZONE
STREET NO. /T /5' pp
Ocd�r LOT DIMENSIONS
SIDEWALK EXISTING YES it Ns ji
BUILDING GRADE ELEVATIONS STAKES SET AT SITE UYt &// g 1( ,ig 9 2. BY s L
FEE: $-0'; 00
/ /N // ( i jo.c.24&E.,Q,
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.
001434
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address gV /Sc
Owner's Name /9.. to 12 1
Name of Subdivision
Lot # /9 Bldg. Permit # 7-75
No. of Units l
Fee Required / tFv , o-i
Fee Paid ( o — ts , 0
Owner's signature ,il(t ` �� Date -3//3/z___,
z___,
Inspector's signature / -0 A,,,a,(4 Date 3/(� /q -
Pa rks Subdivision
Improvement
Accts. Rec.: 362 - 041
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