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HomeMy WebLinkAbout0022749-Building CITY OF OSHKOSH N9 22749 PERMIT - APPLICATION AND RECORD TYPE: BLDG NI HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING 1 FLOOD PLAIN HEIGHT ADDRESS a , 5/ 1A-CAA- i PLAN NO. G3l2-03S/• OWNER e-VO DESIGNER USE /NATURE OF WORK J t t () j I 't - L�� • W A.I.rl� C�.l ' BUILDING CONTRACTOR /8 X ,2eek). , 9.T ... Ge. /✓7a1-Q4 -C 7,IgY t.1J Size � Sq. Ft. 9 # Rooms - 2-0.A1 # Stories Height Z-0 �/ Foundatio £ 4t.- Class of Const. Occupancy Permit HEATING CONTRACTOR 4/uw l>ti Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR L fri-tr Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR , eQ %4- BT WH Disp WSoft CBasin _Lax/ Sh DW DF San. Sewer WC FDr SP Ur Storm Sewer Sink LTub Eject SS Water Other FEES: Valuation 3 19z019 • D4 Permit Fee Paid $ /- 7• CO Park Dedication $ /D©. 0 0 ISSUED BY / -I Date 3A-07 Final /O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. ��e .i , , y SIGNATURE 2 a6 AGENT /OWNER D E ADDRESS L ' .-_-..r, ` 1 ` 4T S (e ,s / TELEPHONE # 6 3 /?O / State of sconsin Departmen of Industry, WISCONSIN UNIFORM Labor 8 Human Relations APPLICATION NO. 7 Division of Safety BBuildings BUILDING PERMIT Box Madison, WI 53707 APPLICATION Wisconsin Statutes 101. 63, 101.73 See Instructions on back o1pink copy) PARCEL NO. PEP I E > » < iHaRi > . SRUCT RE U HVA ❑ C E LE c�1J T ❑ C PL MBIN ❑ PLUMBING Owner's Name rr Mailing Address Telephone G rrey bEc &pr «l_ 0 sn �- Z -1. Sz; &- Contractor's Nam Mailing Address Telephone 1 /4, SECTION T N, R E (or)W Building Address Subdivision Name Lot No. / Block No. p Zoning District Lot Area Front Rear Left Right Righ /..- Sq. ft. Setbacks °2 S n c( 3 ` 1 Zft. / . S ft. / e S n. � A >: «: :: <:>r $ A :..; . . .... ELF "?R�.�A�.:<. 1::. ' . . i . >; «««:;::::;: ls��M' ... :: ::1:�.::ENERt��.:URCi�.: : : ::.. ;i New ❑ Addition ❑ Raze_ Ingle Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar Al teration ❑ Repair ❑ Move ❑ Two family Size: / 00 amp ❑ Radiant Baseboard or Panel s * ❑ Other _�Sey ice: ❑ Heat Pump Space Htg. ❑ ❑ ❑ ❑ ❑ ❑ Other 14 Underground ❑ Boiler WaterHtg. ❑ ❑ ❑ ❑ ❑ ❑ Overhead ❑ Central Air Conditioning fib::::; :: «:: ❑ Other * ❑Dwelling nit will have 3 kilowatt or .................. • more installed electric space heating equip. ite con r on crete 0 ; :':PI IE i11 IN :::: ::::: :::::::: ::; :::: Infiltration control option is: ❑ Full sealing �ttached ❑Detached � st ucted 9 > . ❑Manufactured ❑ Masonry Sewer of joints. El Blower door test. ❑ Exterior ::.:...........;.>; «« «::<:::::: >:««« : Treated Wood unicipal air infiltration barrier. ❑ Other Septic ::: ..:.. :.: .. ..:. .: ..: :: :.: ;;;;;;::. :<.... Basements sq. ft. :: l <S1�# 1E : ><::< ::::...:.:.:.... : :: ::I :::} ATLOSSICaii l2Et j < >< < <: Permit No. (l m �RTU /HR 9Cr7 ❑ 1-Story v < > > > ? < > > > Envelope 19 , Living Area Q Sq. ft. Sto Seasonal '1 >'�' >: :, ....::r:' <'< > >s> � ❑ rY ❑ a �...�����. ...... Infiltration � � OS'I 9 BTU /HR Garage �.J 2-5 Sq. ft. Other ermanent unici al Utility >14 E iY ii c i6de tic° her ❑ Private on -site Well 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 nab' ity, express or implied, on Department or Municipality; and certifies that all the above information is accurate. SIGNATURE OF APPLICANT '/�1/ DATE CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to com y may re / ''/ n suspension or revocation of this permit or other penalty. � 4.)_ , ___,.., LL /�i /4- A / R � �• , 0 • , ' _ i .,,,,,,/ O•s f✓ _ __ .. . iste, c otter -- / i/'-- . Z i�a _ _ � _ cl e..44.6 a €47 . / ❑ T OWN Municipality ❑VILLAGE CITY 0 COUNTY Nu mber of Municipality Number of Dwelling P tY 9 :- ««:: ❑ STATE ❑ INDEPENDE Inspection Authority Location, if different ?> I t>�t. #�tYt IFORfERMW ; ........... Plan Review . . . $,) onstruction Inspection $ ❑ HVAC NAME t./ii.G� ``'' ❑ Electrical / i Wis. Permit Seal(s) $ * S t e ❑ Plumbing 9 / 6 DATE ��� Other $ ❑ Other TOTAL . . . $ 7 Q CERT. NO. 5 5-0 SBD 5823 (R. 4/89) WHITE — Issuing Jurisdiction YELLOW— DII,HR GREEN—Inspector PINK —Owner /Agent P'c'oth ov /o Ae/e t h Revised: 8 /89 ZONING /LAND USE COMPLIANCE CHECKLIST JOB LOCATION: .SiL°f/` ict ZONING: ff PROPERTY OWNER /CONTRACTOR: ft eel— V • CONSTRUCTION DATA: ANEW CONSTRUCTION ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.) iercvt) a,157`714 COMPLIANCE CHECKLIST (Check only those applicable) COMTES DEFICIENT DEFICIENCY /COMMENTS i 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 AUTHOR 1 TV: _ l(,0 The Director of Community Development, or d signee, 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 4 61117 REVIEWED BY: . �'% DATE: Z S DATE NAME z/ ` /�' �i��/� ADDRESS LOT /$( BLOCK WARD SUEDIV. c4 ( C /1 ZONE STREET NO. LOT DIMENSIONS SIDEWALK EXISTING YES . NO El- BUILDING GRADE ELEVATIONS STAKES SET AT SITE - 5/ Z S ,19 'I B Y �]J FEE: / /J�/C/ 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. 41 r • , . • ' • 004 / 4z /7c City of Oshkosh 1/ PARKLAND DEDICATION FEE COLLECTION RECORD Address 5 Owner's Name Ag. /0-1-4e2 Name of Subdivision z li e t0tideCe e Evod-ber-ga- Lot # Bldg. Permit # 2 - --1 7C / 9 No. of Units / Fee Required / R 6-4) Fee Paid / 8-0 6 Owner's signature j ,4 Date 3 G Inspector's signature �A , e ., Date 3 - )-.4 Parks Subdivision Improvement Accts. Rec.: 362 -041 cic ( J. ia , CV 1 /o - , • CY ti 6 „ 91 oLs' Oo F °y Q+^ > ' q � " b K l � 7 OWNER ADDRESS T 4RS DATE PERMIT # USE Work consists of GENERAL CONTRACTOR MASON CONTRACTOR - ZONE Width of lot DATE INSPECTIONS REMARKS Aar V A 4. aA ro 0 V • o A . a Front of lot MAILING ADDRESS