HomeMy WebLinkAbout0047138-Building 110
CITY OF OSHKOSH N2- 47138 PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING S\ FLOOD PLAINOt± HEIGHT ( U
ADDRESS 31 d11 Q l t c :el PLAN NO.g "OI < I /ti'i IV
OWNER RO3 c).-i
DESIGNER
USE /NATURE OF WORK Nk 1� Y�
( x i C v \ ink c.;-.1)
BUILDING CONTRACTOR kJX
SizeSlt Sq. Ft. `IS114`10 # Rooms( 9 }r # Stories A, Ieve
Height 18
Foundation ro f-c, k. Class of Const. @ Occupancy Permit Pt-V;
HEATING CONTRACTOR Pi e--C
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR ( I w+■ ft )--C
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTO
- 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 $ Li ✓ O
J Permit Fee Paid $ / Park Dedication $' (X�
ISSUED BY-7X Date 1 --c /5 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
.7 ijc_
SIGNATURE
AGENT/ ER ATE
ADDRESS
TELEPHONE #
ZONING /LAND USE COMPLIANCE CHECKLIST R JOB LOCATION: ) X 17 i7)4_ J j4 11 c>C. ZONING .1
PROPERTY OWNER/CONTRACTOR: �V
CONSTRUCTION DATA: New Construction Addition Alteration
• TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) S� °-i- -l-f- �o cy- clQ
COMPLIANCE CHECKLIST
DEFICIENT COMMENTS
Use
Lot Width
Lot Area
Lot Area Per Family
Floodplain
Front Yard
Front Yard Side Street
Rear Yard
Side Yards
Building Area
Parking Standards
Off - Street Loading Standards
Vision Clearance
Transitional Yard Standards
Landscape Standards
Height
Conditions of Approval
Compliance with P.C. or
BZA Conditions of Approval
Signage Standards
Drainage Plan
C-01 e‹._*" $100 & Irk,
REVIEW AUTHORITY
As per Section 30 -5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or
designee, must approval all plans, except the following: (1) Alterations or interior work when the use is
conforming and when no change in use is proposed. (2) Maintenance items, e.g. siding, windows, etc.,
when the use is conforming and when no change is proposed.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: 6S DATE: 9 —
Wisconsin Department of Industry, WISCONSIN UNIFORM BUILDING Application No. •
Labor and Human Relations- PERMIT APPLICATION
Safety and Buildings Division
P.O. Box 7969 (See instructions on back of pink copy) - Parcel No.
Madison, WI 53707 The information you provide m7/ be used by other government agency 97 / 8
Wisconsin Statue 191.63. 101.73 programs [Privacy Law, s. 15.04 ) (m)J.
iiii$!plERMIlifiggkg$7110iiid D Constr 0 HVAC El Elec El Plbg ❑ Erosion ❑ Other:
Ow is N Mailing Address f)-CA (ele , hone/ o.
c /h.. Canal • 0760 W. nc� )2 3/ — 8
Con actor's Name: ❑ Con fi ec • HVAC ❑ Plbg Lic/Cert # Mailing Address Telephone No.
/ i47 •( )
Contnctor's Con Q Elec VAC ❑ Plbg Lic/Cert # Mailing Address Telephone No.
12/1J,L14A '/ /, ( )
Cgra or's Na e: ❑ Jn f lec ❑ HVAC p'�Ibg Lic/Cert # Mailing Address Telephone No.
Contractor's Name: ❑ Con ❑ Elec ❑ HVAC ❑ Plbg Lic /Cert # Mailing Address Telephone No.
t�!!��.�!t ( )
? Jti OCA , N « u d Lot Area
.............. ....,:: s >I Sq. ft. 1/4, 1/4, Section , T N, R E (or) W
Building Add ess Subdivision Name Lot No. Block No.
31'77 (✓1�:t�,. , li 38
Zoning District(s) Zoning Permit No. Front I Rear Left Right
Setbacks - ft. ft. ft.
CT ....... ............... .. u' K. �wMfii:'17i�C�;. . :�t�:.:
iirE�i: : .�Iw�•7�� :. :�r. �S� kiwi . :
> X �: `� ;:::::::: �S::s:::::::::::::::::::;:
ew ❑ Repair Ingle Family Entrance Panel y orced 'Air Furnace N L. P. Oil Elec Solid Solar
❑ Alteration ❑ Raze ❑ Two Family Size: /0 0 amp ❑ Radiant Baseboard or Panel Fuel Gas i *
❑ Addition ❑ Move ❑ Garage Seryice: ❑ Heat Pump
❑ Other (print): I ' Underground ❑ Boiler Space Htg ❑ ❑ ❑ ❑ ❑
❑ Overhead ❑ Central Air Conditioning Water Htg ❑ ❑ ❑ ❑ ❑ ❑
❑ Other ❑ Other * ❑ Dwelling unit will have 3 kilowatt or
A` "" S '` ^ ` N n more installed electric space heating equip.
ite Constructed o
ncrete iiikinomppo > Infiltration control i n is : Full sealing :. o t o
❑ Manufactured ❑ Masonry " "'° " °" of joints. ❑ Blower door test Exterior
.. . .. > .....
..
'` •" ❑ Treated Wood Sew air infiltration barrier.
STORES # » > < Other unicipal » > >:.; ::::::::::::.;•:.;•::.>:.::..::.;:::»:• ::::.:.:::::.:::::::::::::::.
Unfinished Basement / ✓7 Sq. ft. : ... , ... : :::::; ::::::'r >IH'#<:''.<
1 Story : :
�/ *`;... ;:.... ::• :•; » >:•::. >; ; >: <•> Permit No. 1�'?g . 7( BTU /HR
Living Area / 7 Sq. ft. ❑ 2- or
y ❑ Se onal Envelope IC) o S32 L BTU /HR
Infiltration
Garage S . Ot ft. r ermanent
IP � .:;;;:• J •; •; :
9 -/' q � '
❑Other unicipal Util ity - .lt+f >< >` >s > »;'•.
❑ Plus Basement ❑ Private On -Site Well $ 5 1 boo
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 implie n the Depart t or municipality; and certifies that all the above informatio is acc ate.
APPLICANT'S SIGNATURE 4.--- ' DATE SIGNED / OS
' APPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may resul in suspension or
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1,
revocation of this permit or other penalty.
i) l / � 4;101' 4. )h 4 0 071;.19 r•N 1'6 0110 1 U .l 5 1...i!ft I1 )"
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Town Village it n
❑ County State of: Municipality Number of Dwellin
❑ 9 Y ❑ Y ❑ P Y Dwelling Location:
JURISDICT OS�IZ c7S "Z �. - R 4
: > :: : :.: `�
.... .. ... ................... . .....
��wy���{ fi r. ��, kt *�y �w �y� .... .... .......... ...............................
:;:;.. ...............:. .... ... :.: :.....:................... : .: .. : : T Tw.i�l�.::: �i7'.: :::::::::::: i�i�::: i��r���:: �: �i�kY11�::::::::;:::<:::;::: �;:::::_%::`::: �: �:%: �. �: .:.;:;:::::':::::::::::::::::: ::::::: :: <:::: < <: <:' < ?:: <::�
..............::.:..:.:::.:::.::.: �:::.::::::::. .....ii ri .. ... ....... . .. . :. .. :. :.:: . : :: :::. .: R1F. 7 .G x:.:::::: :::::::::::::::::::::g:::. ::::::. ::. :: ::
Plan Review $ 1 10 " ...4 ,..! Construction 0 •
Inspection $ H VAC Name D°Ne / I ..J (.) tic).--1
Wis. Permit Seal $ SD ❑ Electrical
Other $ ❑ Plumbing Date q `2o
9s
Total $ '� C7 O rOsion 14D 317 Cert. No. 593 S
SBD -5823 (R. 06/94) WHITE - Issuing Jurisdiction YELLOW - DILHR GREEN - Inspector PINK - Owner /Agent
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c N +, E st b°
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VI/11111f $ 11 $3 1
0 ¢
111:12.61 yg c N
+ 4 V o % 3 g . 2 S
U O 0 (2 tgo3i:L! 6 4 Y
J 0 p r .e Y $ 6
U tIl l i i
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CATE 9 ) a- S
NAME ,JS c � ADDRESS (aa
LOT BLOCK wARD
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SUBD I .\14 \\- 5`k,r ZONE it 1
STREET NO. ? . C\- ��Q LOT DIMENSIONS
f_: 77 - ree
SIOE1ALK EXISTING YES , p
BUILDING GRADE ELEVATIONS STAKES SET AT SITE '3 ,19 ?S' By ed
FEE: $15.00
/4/../`‘e
DEPARTMENT OF P U S L I C 'WORK 1, the undersigned, owner or agent of the above described property agree ro have the
grace estaaiished before excavation has commenced.
dr'f s• #.
c014
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address 3 )co Ii
Owners Name CLv! \.„
Name of Subdivision V ,1'� y _ Cr f 20
Lot # g Bldg. Permit # 1 17/36
No. of Units 1
Fee Required / 00 "
Fee Paid /QQ
Owner's signcture � Date
Inspector's signature e j9Q2> Date ^ 3 "
Parks Subdivision
Improvement
Accts. Rec.: 362 -041