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Home My WebLink About0021325-Building CITY OF OSHKOSH N°_ 21325 PERMIT - APPLICATION AND RECORD TYPE: BLDG jg HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING —1 FLOOD PLAIN HEIGHT ADDRESS o919c1 iiii/L;e41/1 4A PLAN NO. 0 OWNER A 4./.4l/'l DESIGNER y� y� /; ,� USE /NATURE OF WORK ) / .(A4) AJ /' • ��t�ci6 ? f%t_ BUILDING CONTRACTOR 6>4 A t - 4a. ) �,� ✓ • .�C!o/ 4 Size /� S Ft. /4 # Rooms t° # Stories JAL Height Foundation &Ir.- / Class of Const. P Occupancy Permit HEATING CONTRACTOR d Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR C Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR 7C)44...4/ 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 i /30f / 0 p• 00 0 $ 1-& Permit Fee Paid $ Park Dedication $ l ISSUED BY r�� Date Pfr/< d Final /O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE w�1 dr astrif • . 1 e / 6 9 AGENT /OWNER DAT' ADDRESS / / l 3 „„ _4! 43 s----go ,fS— TELEPHONE # a S'' /6,r //9 ,- State of Department f Industry, WISCONSIN UNIFORM Labor & Human Relations .. - /3 2 s" Division of Safety & Buildings BUILDING PERMIT APPLICATION NO. Box Madison, WI 53707 APPLICATION Wisconsin Statutes 101. 63, 101.73 See Instructions on back of pink copy) PARCEL NO. T S R T UC URE HVAC E LE 111 C P ❑ PLUMBING Owner's Name Mailing Address Telephone Jt ,< £? ?t6 6V / /i3D� D��. l-/) d73 -/b Contracto r' ame M in Addr ess Telephone P ROJECT L OCAT %, %, SECTION , T N, R E (or)W Building Address ' c ,I1 Su ivisio Lot No Block No. Zoning District Lot Area Front , Rear / PE Left Right £ — / Sq. ft. Setbacks ' ft. C7 / • Z�. ft. ft. : : i]:i: .:.: R: . : ' ��` t�E . ' :::::: .::: .�.. ..Et.�"#A�A�.::<:<: ::. ;�.: : t;�tEi l«+ : IIE' ::.;:::.:.: ; :: �:2. ENIrRG'�;$OI��i#'.E::: : <: < <::; : J New ❑ Addition ❑ Raze N Single Family Entrancepan�l Forced Air Furnace Fuel Nat. L.P. Oil Elec. Solid Solar Alteration ❑ Repair ❑ Move Two family Size: (/ CC/ amp Radiant Baseboard or Panel Gas • ❑ Other Service: ❑ Heat Pump SPdCe rng• ❑ ❑ ❑ ❑ ❑ ❑Other AJ nderground ❑ Boiler Water Htg.' ❑ ❑ ❑ ❑ ❑ ROverhead ❑ Central Air Conditioning ❑ Dwelling mt w .�;�. : :< F��>��I.;. _._,.....�. ......... more installed e lectric ill space have heating 3 eqkilowatt uip or . 6 ( y�� { Attached Detached SiteconstruCted AI` Concrete <�� : : : :UM� ?<<< Infiltration control option is: ❑Full sealing • etl Manufactured Masonry Sewer of joints. ❑ Blower door test. ❑ Exterior ❑ Treated Wood Municipal air infiltration barrier. 7/ ❑Other Se :..:.. S� fi r.. :. 8T I E',G:: >:: tic :.:: :. : .: ::.: _..._..... Permit No. ._, : :Mi:i: A'1� LOSS : >. Calcilitt Y : :i: : : :< : :: : :: Basements Sq. ft. (; ,� ; a' . > » > > _ > > >> Envelope '3 BTU /HR Living Area l 7 Sq. ft• ❑ 1- Story . ::<::::,::.::.: ;::.::::::<;:.: ❑ 2 -Story ❑ Seasonal t:: :WA I LS : :<:«< :: :>:> :i«::::::: Infiltration / /4.3S / :... lltr BTU /HR .ct0 / g Ot er Pe rmanent Garage Sq. ft. IR ` Municipal Utility 1I0;T>< €` . ./u LJ Other 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 liability, express or implied, on e Department or Municipality; and certifies that all the above information is accurate. ` SIGNATURE OF APPLICANT DATE / /// t" e) CONDITIONS OF APPROVAL This permit ist issued pursuant to the following conditions. Failure to comply may result in suspension or revoca o f th permit or other penalty. ,i i / di. .tl—r . / s . ! i / La L .:,.rte / 2 / . 3v �_ w he E - v-oSo ,9 0-.71 - ( / TOWN ❑ O VILLAGE Municipality ❑ LAGE CITY 0 Number of Municipality Number of Dwelling P tY .,"< ❑ STATE ❑ INDEPENDENT Inspection Authority Location, if different OF DQJ� 2-4 ? O - � - - - - -- <' >PE : _ . ............................... :: ::.:::::::.:..::::: . ISSN Sir ........... . Plan Review $ +/-0, 0.0 Construction � .. .. :< : ............. ❑ EVAC F6 F 9 6 - , NAME Inspection ACaete.11e-- ❑Electrical _ Wis. Permit Seal(s) $ 30 • ©Q ❑ Plumbing DATE // / S / / 0 Other $ ❑ Other TOTAL . . . $ 70. 00 CERT. NO. SBD 5823 (R. 4 /43jf 4 9 6 0 WHITE — Issuing Jurisdiction YELLOW — DILHR GREEN — Inspector PINK — Owner /Agent Revised: 8/89 ZONING /LAND USE COMPLLIIAANCE CHECKLIST JOB LOCATION: a 4790 .A4(7,( G i /off ZONING: 207/1 PROPERTY OWNER /CONTRACTOR: CONSTRUCTION DATA: L AEW CONSTRUCTION ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.) 4 e 7 a$:/ Az/f . 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: (ihikt G) 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. A PPROVED DENIED Plan Commission Action Required Variance(s) Require REVIEWED BY: '/� DATE: if City of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address v? 4 ,�2�/Llis. ' ,4 1 _, J i s / / n� Owner's Name CiC.�f/�. i /� Acer 9✓ / Name of Subdivision Lot # Bldg. Permit # .132 No. of Units Fee Required /00 • 00 Fee Paid /00. 00 Owner's signature /.r~i-...L • . 411!_ , 4 > Date &4/ Inspector's signature . ' ,r6e,ai.y 4, , Date / /b Parks Subdivision Improvement Accts. Rec.: 362 -041 DATE /0 0 2 `f /90 NAME AeekA./ ADDRESS LOT 2 ✓ BLOCK WARD SUBDI V. � ,46,Gwiii L ZONE STREET NO. c , 2 O 1- 4- 7 4 - LOT DIMENSIONS SIDEWALK EXISTING YES [::: NO BUILDING GRADE ELEVATIONS STAKES SET AT SITE ,19q0 BY V Ni FEE:$10.00 67; • .4;"' 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. f 004 259 11 1 7 / 1 ., I' I, dl__ i q'g ( 1 1 cx , . i 1 �ti sy' I I � l 1 `� k-6 � , - 4 7 ` Ni , S I N S , • En' in _....... . 1. , 7' 1 1 i 16 � • 1 6' • I j` t q 'k, J - , y�. ( 1 ` s n q A s • /•' .\ "7 1 t v) ' J1-4-- ',toot- 7 vij,,,,,„,,bia,,,) sA y g 0 . ,<U,,,t,t...i6a,,,c) .