HomeMy WebLinkAbout0019034-Building CITY OF OSHKOSH N2 19034
PERMIT - APPLICATION AND RECORD
TYPE: BLDG X HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING 41_ FLOOD PLAIN O
ADDRESS ° -.' re PLAN NO _ ( J " 6 pnk_
OWNER .egAl /21-Cdi.)'
DESIGNER s(��
USE /NATURE OF WORK ke. 1.1 / ,.7. e • W j'�1) � -•f• --
BUILDING CONTRACTOR "
' /
Size — Sq. Ft. /77 ��L/ V # Rooms L aJ` 't / # Stories 71; vey Height 'e.jZ-
Foundation 1-721/1/2 Class of Const. 2' Occupancy Permit kr .
HEATING CONTRACTOR C.-0rt- i
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR vVcZ -t: &(..0-•
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 $ 40 DOD, 0 Od 00
� Permit Fee Paid $ ��Qi Park Dedication $ l04 • 0
ISSUED BY i Date /� //1 Final /O.P. _ '
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATU Al 0-4w n. • .� -/ s
/�P AGENT /OWNER DATE '
ADDRESS �I ` ,on.itAil
TELEPHONE #
p 3 - 9 ' 3 - / 9 9 . 0e
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM �3
BUILDING PERMIT
Labors Human Relations
Division of Safety & Buildings APPLICATION NO. I
Box 7969 WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 See Instructions on back of pink copy) PARCEL NO.
PER ATR"
A ELEC PLUMBING
STRUCTURE
. . ::: 111 HVAC ❑ C ❑
Owner's Name :::::.:::. .::. . . . . . ..: Mailing Address Telephone
A D. 1. 2A/ /// 3 &sue',` -,%' .s 3 -- Pe 3 �'"
Contractor's me Mailing A dre Telephone
.. ...........................
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..0 > LOCATION< < > < < < < < < < << <<
E ;: ;;;;;;...;;>;:::;;>;;;;;:.: ,:,, : :
.................. /4 /a SECTION T N R (or)W
Building Address Subdivis' n Name Lot No. Block No.
C3 3/0 .X L / Z
Zoning District Lot Are Front Rear Left Right
R"' 1 5G to - Sq. ft. Setbacks .P S ft. 4 I •7f ft. 2' ft. ' ft
la PROJECT WiTYPE ?> < > 6 > ELE RI A 9 < `ACE I < «< < < 12 ENERGY SOURCE < < '< «««<<;
........ ...............................
IN New ❑ Addition ❑ Raze IN Single Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. Solid Solar
*
❑Alteration ❑ Repair ❑ Move ❑ Two family Size: /OD amp M Radiant Baseboard or Panel Gas
❑ Other Service: ❑ Heat Pump SPace Eft g. g ❑ ❑ ❑ ❑ ❑
❑ Other I$ Underground ❑ Boiler Water Htg. ❑ ❑ ❑ ❑ ❑
❑ Overhead ❑ Central Air Conditioning
* 0 Dwelling unit will have 3 kilowatt or
.. g: :.::.::<: .:::< <:.:
..:: �: «' ;Z::F00N04 El Other •-- more installed electric space heating equip.
L'J Site constructed Concrete '� ; ] MI$R1 ; ; ; ; ; ; , Infiltration control option is: ❑ Full sealing
Al Attached ❑ Detached Masonry Sewer of joints. ❑ Blower door test. ❑ Exterior
.;: ❑ Manufactured
air infiltration barrier.
sIkR�A €«< ;. > > > >` > > > » > > _> Tr eat ed Wood
❑ (g) Municipal
Basements Sao / sq. ft. :;: ❑ Other ❑ Septic r > : : .: ... :: :...:..: c::>:;; :. ; ,—
i< ORIE$: >:«::<: >: P 3 <:: A ':: O;SS::: £810 1att }:::«: >::> <: ;
Permit No.
❑ 1 -Story ' > < << < Envelope ••B ZeeO" o9 BTU /HR
Living Area 24 Sq. ft. 7.6-4•02-BTU/HR
SG .i�
7
2-Story ❑ Seasonal Infiltration �
57 z i Other Permanent
Municipal Utility 1t>':QTR8U
Garage S ft. p tY .
Other
Private on -site Well
$ i 000 a00
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, .n the D- .artment or Municipality; and certifies that all the above information is
accurate.
SIGNATURE OF APPLICANT /A miuh. an - , DATE 2 - 2 - -
CONDITIONS OF APPROVAL This permit i- • - - _ . pursuant to the following conditions. Failure to comply ay resul in suspension or
revocation of this pe it or other penalty.
/LFl,i o' -3,08 (thc A .✓n.✓- M6TALC. /G fuc-rV cox Ki7 i:we,' /r004) S
❑ TOWN ❑ VILLAGE RI CITY ❑ COUNTY Municipality Number of Municipality Number of Dwelling
«:: ❑ STATE ❑ INDEPENDENT Inspection Authority Location, if different
R t D o 6 6
>' >:> PERM :
;ILtIKt.
Plan Review 1 7 10 . . S �' 00 g Construction HVAC `
NAME Pit4f he 1-
Inspection . . . . $ ❑ Electrical /
Wis. Permit Seal(s) $ 3 0.0 0 ❑ Plumbing DATE 6./ 9-0/ / p
0
Other $ ❑ Other /� / / a S �
TOTAL . . . $ 70400 � ✓ �""� CERT. NO.
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: 0 2 5 3 1 2e ( /Z- ZONING: 1=r r
PROPERTY OWNER /CONTRACTOR:
CONSTRUCTION DATA: NEW CONSTRUC11 ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, poo , sign, deck, etc.)
ec./L_3 .S x Z
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (fr rt 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:
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.
L/ APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: , e�_„_r�.`�- - DATE: 7 9/1Z
City of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address a 6-35 (IF
Owner's Name MAA1 /9,,e.e 1
Name of Subdivision das''
Lot # / Bldg. Permit # /90 3 7
No. of Units
Fee Required "OD d
Fee Paid $/M, Be 0
/ __ ��
Owner's signatur: �y .�.r ,_ ‘ - Z Fe)
Inspector's signature i 2 • / « ,,r,. Date - , °a
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
DATE – 1 g '0
NAME G._c r- –' �J � c ( G Pi'— ADDRESS /j)-3 te7
LOT B LOCK WARD
SUBD I V . e •-c`So r_p \(c ZONE
STREET NO. S ke i`cQo v.. $ LOT D IMENSIONS
SIDEWALK EXISTING YES LI NO
BUILDING GRADE ELEVATIONS STAKES SET AT S I TE�U� ,I9 90 BY _
FEE: $ is . 00
(SI°
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.
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NOTICE
SECTION 7 -32 CERTIFICATE OF OCCUPANCY TO BE ISSUED
(A) The Building Inspector, Heating Inspector, Plumbing Inspector,
and Electrical Inspector shall make a final inspection of all
new buildings, additions, and alterations. If no violation of
this Chapter or other laws or lawful orders be found, the Chief
Building Inspector shall issue a Certificate of Occupancy,
stating the purpose for which the building is to be used, also ,
the maximum load and maximum number of persons that may acc-
omodate on each floor thereof and also that the building or
premise or part thereof and the purposed use thereof are in
conformity with the provision of Chapter 30 on Zoning and
City Planning, as required by Section 30 -27 (C) of said Chapter.
NO BUILDING OR PART THEREOF SHALL BE OCCUPIED UNTIL SUCH
CERTIFICATE HAS BEEN ISSUED. NOR SHALL ANY BUILDING BE OCCUPIED
IN ANY MANNER WHICH CONFLICTS WITH THE CONDITIONS PUT FORTH
IN THE CERTIFICATE OF OCCUPANCY.
PRESENT THIS CARD Code Enforcement Division ROUGH
FOR OCCUPANCY PERMIT TO Room 205, City Hall ����
Oshkosh, Wisconsin 54901 City of
THIS BUILDING SHALL OSHK OSH
\OT BE OCCUPIED U\TIL Rou
•
H E � ECR I
FI\AL I\SFECTIO\S A P 1 T
,t y o 1
HAVE BEEN VIADE A\D f
OSHKOS DATE
INSP ,
THIS CARD SIG\ED BY
THE FOLLOWING I\ - INSPECTIONS MAY EE
S P E C TO FR S ARRANGED EY CALLING
K 236 5050.
B UILDING /0
' C DATE i°-3-g
� f
E LEGTRICAL4// -22--
H EATING
DATE 1 _a
P LUMBING 4 DATE ' /-2s c)
*FIRE DATE