HomeMy WebLinkAbout0025582-Building ., ® CITY OF OSHKOSH N° 25582
PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 37 0 /SAM l% PLAN Nar- 09 f/09(,
OWNER ei.e 4
DESIGNER J/�
USE /NATURE OF WORK 7Pd-4✓ /14 a-
BUILDING CONTRACTOR 19/,(sze -c.
Size Sq. Ft. /S16 / # Rooms 6' ` 344, # Stori s / Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR 4tt.f.o.-i'iC-
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR /.l
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR A4
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
1/
FEES: Valuation $ 7".5 1 000. 0 0 Permit Fee Paid $ P'12- • S 0 Park Dedication $ / 00 . 00
ISSUED BYP Date /0/3/f / Final /O.P. / -£S - Y,
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURAL M1 .1-arre., . _
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
_
. ,
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM
Labor & Human Relations
Division of Safety & Buildings BUILDING PERMIT APPLICATION NO. „,2 5
Box 7969
Madison, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 (See Instructions on back of pink copy) PARCEL NO.
PERMIT soatoosttogu
. CONSTRUCTION 111 HVAC 111 ELEC 111 PLUMBING El OTHER:
Owner's Name Mailing Address Telephone
Contractor's Name . Mailing Address Telephone VS V3(.3'
ete)&aa /4 1,,,,,, hi:a/4e (i7aaide,e-ii- 4e2-4o- 197 3
pRO4goribtAilOttiiM
Sq. ft. %,
%, SECTION , T N, R E (or)W
Building Address ,, Subdivision Name Lot No. i Block No.
70
c7 te idIA-41,144" Eti-ot.-6
Zoning District(s) Zoning Perm No Front Rear Left Right
Setbacks 3° f (Fs' ft. ( ft. ( ft.
1 PROJECTAMMEMP:: 0401401aridta :W:ELECTRICAL::::::::::,ilirilifAMECIUIPMENT:::::::::::::::::::::::::::::::::::: 42 ENERGYSOURCC':::;:::::::::::::::::':::::iR
Jew 0 Repair / gKingle Family Entrance Panel IcF Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar
Gas
Alteration 0 Raze Two family Size: 7...0e) amp Radiant Baseboard or Panel *
0 Addition 0 Move 0 Garage i 0 Heat Pump Space Htg. x 0 0 0 0 0
0 Other Jnderground 0 Boiler Water Htg. t 0 0 0 0 0
Overhead 0 Central Air Conditioning E
0 O i#4kiiMtWrept lapowokropc 0 Other * 0 Dwelling unit will have 3 kilowatt or
more installed electric space heating equip.
,...... • ..,...,.... .. .,,,,,,..• • . ..............................................................:.
.18CSite constructed 8cConcrete :104:::::Pki ............................................................................ Infiltration control option is 0 Full sealing
Manufactured Masonry - of joints. 0 Blower door test. 0 Exterior
0 Treated Wood rurnicipal air infiltration barrier.
..... ................. ................-. —
!,,! El Other Septic ,43::::::::11EOLOSS::::"Cilbiiiiiiiid)::::::::::::
Unfinished Basement /4?sci, ft, ::$:::::;STORIES:::::::::::
Vusgmenim Permit No.
s H VI.1-Story . • ... • .. • . • . - . • ... - ......... •••••••••••.........-.....-...-.....-......... Envelope 2- 5 3 BTU/HR
Living Area /V ?
41 ' — 0 2 0 Seasonal :t.C::::::****:::::::::::ii::::::::::::::::8:::::::::::i::::::::::::::::::::::::::::::::: Infiltration / t f 2 -32--- ,7 S BTU/HR
Garage 7 ?(-- sq. ft. 0 Other Permanent LI Utility *C
Other 0 Private on-site Well
_ 0 Plus basement $ ?S 0 0
The applicant agrees to comply with all applicable codes, statutes and ordi ' ces a 4 . with the conditions of this permit; understands that the issuance of the
permit creates no legal liability, express or implied, on the Department - • 'pair:, and certifies that all the above information is accurate.
SIGNATURE OF APPLICAN illit riiii± 4 rnk "-alai- DATE
CONDITIONS OF APPROVAL permit is issued pu suant to the following conditions. Failure to comply may result in suspension or
,. • ation of this permit or other penalty.
» ,..d..--,,C /...54 44
iSSUING -44.-/-;
............................
,,,-,,.,,-,,.,,-,,.,,-,.,,...,.,.,,-,:.,:-,:.,:,,..:::,,.:,:::::::::, CI TOWN 0 VILLAGE A CITY 0 COUNTY Municipality Number of Municipality Number of Dwelling
Ra::ii:iimmi
0 STATE 0 1 DEPENDENT Inspection Authority, Location, if different
.::4urtisoitatog:,:::::: 7 ...7.,- 6 6
_ _____- ___ _
PERMtT(S) WIS. UP4IFORM PERMIT PE 1
ISSUED SEAL RMIT SSUED BY.
s Construction
A ztaiz i o.i
Plan Review . . . $ 40•0 0
El HVAC NAME
Inspection . . . . $ 0 Electrical C i t 7 f/7-7/'
Wis. Permit Seal. $ • ■ ri 0 0 Plumbing DATE
Other $ El Other
TOTAL . . . $ - 7 0 t C CERT. NO.
SBD 5823 (R. 8/90) ce WHITE - Issuing Jurisdiction YELLOW- DILHR GREEN - Inspector PINK - Owner/Agent
•
Revised: 8/89
ZONING /LANG USE COMPLIANCE CHECKLIST
J08 LOCATION: 02670 / c�a .�
ZONING:
PROPERTY OWNER /CONTRACTOR: Zap 4.•
CONSTRUCTION DATA: CONSTRUCTI{N ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
a-a s 1,/
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: tom/ a/he * /�+
The Director of Community Development, or designee, must approve all plans, except the
following: (1) Alterations or interior work when slhenuse onfo ri a ndn w he n n
in use is proposed. (2) Maintenance items; e.g. g, windows,
conforming and when no change is proposed. the
Instances where work complies with the
above Communityt0evelopmentieQeddesignee.
Building Inspector without referral
L APPROVED DENIED
_ Plan Commission Action Required
Variance(s) Required
RUINED BY: ett., r AlleA I' DATE: ,0 /L /Fj
ir
DATE QT I
NAME C is 14 (s ' G oft e ADDRESS
LOT 8 BLOCK WARD /Z--
SUBDIV. �YI�F �4 pv L4 ZONE
STREET NO. 4-1 Esf— LOT D I MENS IONS
SIDEWALK EXISTING YES [::: NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 9 /27 ,19 9/ BY 1214
FEE : 1 -. OO
GPMI- /rd4A/A-
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree ro have the
grade estaaiished before excavation has commenced.
0
�"�� (
City of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address c2 5 /O / 44 ieeer4• /fr
Owner's Name ( ,t
Name of Subdivision JAZ"(
Lot # d Bldg. Permit #
No. of Units
Fee Requi red
Fee Paid (4`O. 0 0 f
Owner's signatu ►;�',;� . /.It A,_11/1/■.- Date
/ F
Inspector's signat V 1, /, .1 s Date /0/3/9/
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
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