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State of Wisconsin
Department of Industry, WISCONSIN UNIFORM /`27�
Labor & Human Relations
Division of Safety & Buildings BUILDING PERMIT APP ICATION
Box Madison, WI 53707 APPLICATION
Wisconsin Statutes 101.63, 101.73 (See Instruction on back)
PARCEL NO.
O gSTR UCTURE ' ,HVAC .LEC ❑PLUMBING
O is Name Mailing Address ivs Telephone
Co ractor's N9me Mailing Address Telephone
'/s '/a, SECTION , T N, R, Elor)W
B;Idin Addres u..ivision Name Lot No. Block No.
se ' - - _ '11": 41 41> +0 p1CoLFT r 1%G6>{OIP 4)-3
Zoning Diltrict j 6 ,Q Lot Area Front Rear Left Right
` Sq. ft. Setbacks / e54: ft. ft. • ft. ft.
' ge a tLE t IL :' , EQ I T Ai. ENE V URIE
': ew ❑Addition I. ingle Family Entra Pan I .7 Forced Air Furnace Fuel Spa ce Htg. Water Htg.
• Alteration ❑Repair II Two Family Size: a mp d Radia Baseboard or Panel LP Gas ❑ ❑
k. arage ❑Raz ❑Other S ❑Heat Pump Nat. Gas
t ❑Move ❑Underground ❑Boiler Fuel Oil ❑
Detached ❑Foundation ❑Overhead
� 4 � ❑C Air Conditioning Electric ❑ ❑
❑Master plan no.
* t 1„, . �. ❑Other Wood ❑ ❑
Of applicable! `
i'Site constructed 1►- oncrete I.> Solar ❑ ❑
a ■ M a n ufactured • r• Masonry Sewer Coal ❑ ❑
A ; . �. ,,, : L/ , ❑Treated Wood Municipal Other
/lI% Sq. ft ❑Other l . .,.
Basements ❑ Septic ;,
Permit No.
2
01 -Story Envelope . Z' BTU /HR
Living Area , 4 /34 Sq. ft. 2 -Story ❑Seasonal _ "" Infiltration BTU /HR
Other
Garage 77,6;7 Sq. ft. ermanent ❑private -on site Well 14 'IS E
Other yMunicipal Utility $ ? el'CD
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Muncipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legal liabi , express or implie.� n the partment or Municipality; and certifies that all the above information is
accurate. 4 �� ^8f
SIGNATURE ///
ATURE OF APPLICANT � ..� + 4...... 4...... DATE
CONDITIONS OF APPROVAL s permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revoca-
:ion of this permit or other penalty.
P - - 4. 1 t . a0(44W)A)G a -SG .6 s- ,5 1 TTY 70 /
- 7 7 , -- 4 ■�.. - L. A Cook-/c2...
cee
r��/�. 1 u _ - 1 M KT- / Gr.-v-7 - 7/- 1 c
1 - - „` i -
V ' ❑VILLAGE firCITY ❑TOWN ❑COUNTY DSTATE
3 s ,; 1 i i NAME O - - MUNIC. NO. _ .0 "�
FEES: C{;3 -711" "a
Plan Review $ SD Construction
VAC NAME�� L (--,41-W
Inspection $ Electrical
Wis. Permit Seal(s) ..,. $ ❑Plumbing DATE b---z i ` .
Other $ ❑Other
T OTAL $ 4e, CERT. NO. `, 5 - 21
b 4----
OILHRSBD 5823 (R 71/82) WHITE — Issuing Jurisdiction YELLOW — DILHR GREEN — Inspector PINK — Owner /Agent
DATE 6 -- /8) -
NAME (344,44rs L0 p,g-(2.- ADDRESS ;L6 L 1/'I 5r
LOT 10.3 BLOCK WARD /.
SUBDIV. /�V b(7164 � /" L r/ fs 'ZONE , 4
STREET NO. e625 PlY2t5015 a LOT DIMENSIONS - 4- -PLO O (A �-
YES LIl • Nib
SIDEWALK EXISTING �/
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 6p - /9' ,19 84 BY /2/"
FEE: $2.00
67 9-4...-c_ d ':1-2.7"------4-2
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commence' / JO
e PrZ
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. / 40. 446 4411111Zzt...,/
J. I F.PPLA CONSTRUG I ION, INC.
$.?6 ENERAL CONTRACTOR - ' � „
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/.S 88
JAMES H. LEPPLA PHONE 739-3598 • 5045 MELMAR STREET • APPLETON, WISCONSIN 54915
4
f STATE OF WISCONSIN -
Depart:ment of Industry, Labor and Human Relations
Safety and Buildings Division, Madison, Wisconsin 53707 wonnslizET
E % lc ' itzitair JOB NAME: CF-41- /G. 2. -E L. DESIGNER C_k -�-- ��
LOCATION: ZONE: DA E 5.3_g/
INSTRUCTIONS: This worksheet is recommended for determining conform-
ance with the Uniform Dwelling Code's Energy Conservation Standards.
Dwellings may be evaluated by the System Design Method or the Accept-
able Practice Method. Heat loss thru basement walls and floors where
insulation is not required by code may be included in furnace sizing
calculations at the option of the designer. System Design heat losses
not exceeding he losses determined thru the code requirements by
more than 1 % are considered - acceptable.
are shone
GROSS WALL AREA: FOUNDATION WALL ABOVE GRADE:
/572
• /a.q
c8a.. sq. ft • / sq. ft.
WINDOW .=- REA:Oglaea size Qunit size FOUNDATION WALL BELOW GRADE: t
- a qz sq. ft. 54rq - - -sq'' ft,.
DOOR AREA: - . FLOORS OVER UNHEATED AREAS: -
4
a ✓r
'i '' 3g sq. ift. .. 2 7 1 08 sq. ft.
`. G�INCi `ARE NE T .�OPAQUE)WALL'ARF OTH .
O THER:
-' j.g
j
i gi p{' _
/S5 2 r 2� �, 5 y, . r
•.— d+wu�rrse,. $ 4i 't P cc ' , ft. .. $�, ft., sq. e
page
. ar
,..„...„ , . I UI 9 vALuEs • ,
. _
;,..
INSTRUCTIONS: Calculate R and U values using TABLE A - in Dwelling
Code Book. Separate calculations for systems having the same insul-
ation but different interior or exterior finishes is not necessary •
_provided -the system with the lowest R value is used in the System
Design or Accepted Practice calculation.
type 1 type 2 type 1 type 2
wall
cav sol cav sol
roof cav sel cav sol
exterior film .17 .17 .17 .17 exterior film .17 .17 .17 .17
siding �, -., - 42 ,82 ext. finish - - -- -
sheathing ,c .tez. insulation 50 Lig -
insulation /q xxxx xxxx framing xxxx 4,3il xxxx l q, g q.
framing 1o.15 ) insulation 3g,
int . -finish ., ' 5 int. finish .0 ;-t6 I.1 5 ..f5
interior film .68 ' .68 - • .68 + .68 interior film .61 .61 .61 .61
,
•F" T/ Pc _ ?.o ?.o _ x,23 �3,7
TOTAL R aS.lii,It,.54 , TOTAL R
"U" = 1/R ,o35 • o c. "u" = 1/R .O Z , ► 023 -
.
f d tril
above grade walls ± Otheviii
- cav sol cav sol cav sol cav sol
•
- xt film .17 .17 .17 .17 exterior film ,41 ,t
- ` ext. finish ext. finish .45 .4-5
masonry ► ;,-Z "
wood- insulation 5
into knish :, i - tt:g�
nraN t�
interior film -- :68 .6P .6S .68 int. finish '1 on-
Insulation . 3 5 interior film „cog ., (0g • - e ' _ t•
TOTAL R .. x,0 '- - i TOTAL R 52.14 ( H (al
r
" IV • l R • ' . 1 - gip . • ._ -�.- n U n = 1/R
r
* 1st thru 3rc� foot . foot below grade
:'. bagt
._ ` blow ". X
: _ grade ; t� •bas ement floor
- no insulation. .288 - • •t9l.
walis • - 5 rigid -board . 113 I r ; , .7)63:
,_ : , tz R 11 fiberglass .072
,..,v . - -• = w./ 2 x 4 framing - :.. .
floors ; no insulation ° .025 27 '
y
S
!,. SVISITIEVI CONSTRUCTION HEAT LOSS .
heat BTU p loss int
n AREA "U" TD
er hour
. _
__tyDe cay. (... X ' 2A - N , qS i, Zb
1 sol. ( a522 X - 1 1 - 5 ) 3't g gs . 9 30 . •
W aII3 type cay.( X N)
_`_ .2 sol.(- -- - x %) -
type cay. ( 1552 x ffo 1 13g1 .o'L 15 2315
1 sot. (' 1552 x -�o ) i5 ,023 g5 30
Z
type? cay. (� ' _
- 2 sol.( x_____%) .
1 , above grade walls lc,g , 20 s 5 2g56o
Tdtf- 2 below grade {3 feet) 6 2 o 61 * ci S54-
3
■ 1
1 windows `T S$ .41 .53C i 5to
gias _s. 2 patio doors • 54 .5g 15"1 -
a. _ . .
dc3c1 1 iv, e-rrei... N-5,4L. _ Sit , i+ $C 45 3
lisit 4 1
z or :t:- I 08 c� 2 a�g VS 3 59
Tn_It , O ut..ve'n'[EO
02Ep.5 TOTAL. Z Q"13 S 1
CODE COMPARISON
ADJUSTMENT FACTORS CODE TD` BTUH LOSS
FOR WOOD FRAMING COMPONENT AREA U
I : cc j studs joists ails above _fdtn ZgoZ . 12 ' q5 2$ 614)
12" . 20% 1451 ails above grade - --
16" _15 % "' 10 ,' fdtn above grade _.. lug __,._25 85 -. - 35i
I
� 2 4 1, 1 7 fdtn above grade _ _
dtn below grade(3, 5o4 _20 lob , (.0855 ._- -- .
roof /ceiling -- -- -( 'z , :029 : $5 - •S2 c. ....._ _
' ET HA
��. LOSS - 4 -
COMPONENT 'AREA r "U" * _ . B'1i l
. .3 . - . walls more than 3 feet 51o0 -01. . : 6$. ..$510 _
• $ "-- below gra .... c , ,
- `' loors -.„ 11(04 .p2 Co_5 A7i :.1 1- 3'.. j.:_
, ^ i • A ..., 1 r- . ,:, 1 ,. ...': , ru 1 .:-.,..f"- O a .., ; 1 .` 7 W-. 11: ` f . 4
. .4....‘.-VI:. ;;; 7,. V_ t'VC2 .
'4 ,
- - ^ -,,,er e^ !c A ,17 . � a LT 1 I C � % • i2 .'R.- 'r4t`
. � .Z . . "ir us . 2 i .7;- 4+- i ,,` , 1 i - S a T. ,. S �,'�J.. ry '' t "‘ . :i ' ''+i^''' •
.,ce „: insiae � �� p ,� .; _ r :, , , .
INSTRUCTIONS: for completion of accepta 'a;e practice method, please - refer to Uniform
Dwelling Code, Chapter Ind 22, Energy Conservation Standards, Appendix Tables A -1,2.& 3.
WINDOW GLAZIIrG:QSingle w /story DOORS: nsulated SIDING: wood (R .77) •
WALLS ABOVE QInsulated glass • Solid wood la1uri(R1.82)
FOUNDATION Qi'riple pane ninsul w /storm
WALL
. INSULATION TYPE: .. WINDOW AND DOOR AREA -PERMITTED Z •
GROSS WALL AREA(from worksheet, page 1)= - square feet.
GLASS /DOOR AREA(from worksheet. page 1) = square feet.
• - PERCENT WINDOW /DOOR AREA = glass /door area
PERCENT WINDOW /DOOR AREA = glass /door area + gross wall area = %
INSULATION TYPE: R VALUE (per inch) •
CEILING -
. REQUIRED THICKNESS(per table a -3): " in cavity - ' 'over framing
FOUNDATION - _
WINDOW GLAZING: Qsingle Qsingle w /-store _ insulated(double) _ •
WALL INSULATION TYPE: R VALUE •
EXPOSED FOUNDATION AREA(from worksheet page 1) = square feet.
(walls must TOTAL FOUNDATION) AREA(includes above & below grade)= square feet.
be insulated PERCENT EXPOSED =Exposed foundation -total fdtn _ square feet.
to be in con PERCENT WINDOW AREA PER.MITTED(see Table A -2) - percent(Z)
formance.) PERCENT WINDOW A.^.EA(window area exposed area) _ "'`s percent(%)
•
z . .
• F
___
.- VOLUME CALCULATIONS: , LEVEL . VOLU`tE ... TD '- - A /C - BTUH HEAT LOSS
50� SI y Basement q 3l 2 1 .018 15 a'2$ I 3.5 (o'Z . - - - -
S o •yti }Level 1 ~`i3 t 2 .018' $5' ,s . i ? ' +
__ — Level 2 . L1tDO .018 _ ` $$ , .5 ,. 4-#d.to .
„
Level :3 .018 r _ i-
1:-
.* I.:FILTRATION _ '
AIR• CHANGES R ec o tiended changes betwe .25 and 1 00 L ,. . 3 Y, _ :
• depending on type construction,'number or openings, a
H ..OSS .:> .. ,
w ` caulk 'etc. • w ' „` °` ^' °' � ,,� { , , x � . w, T )
.
N
ALLOWABLE - HEAT L0SS from a e 3
(from t5 s "T , 3 ' e ., ` Tt< £4 i S , •, D. ,1 ,., wr
INFILTRATION LOSS (from above) i- -1 _ G = t' S 3 : • � t, �, f ” ; .;
__ I. � •� .. ' , 1. ; � _ - . • ., 1.15,,_._44,
E $ HEAT .CO�SS (from pa ge `3) ' — , j 5jq '` {� r �_ T ` T 1 � } ��• t
K . " - + 3) ► i r i if _L _ -. �% J► o 7 } 'i 141p∎ „ pm j F .aa 7 a . 4 ?r 4 4 , --. • ,TOTAL .aWELLIUG HEAT . LASS q-It r t , .
3 + c oz y i �� - lar t8i � PCi1F • Qr►c+i�a'+ f.i,
y T Y� is • X14 : . y ta} i�C ' i� 1 < r { '4 0 J K r,s.,R�„ . 4 .,} 4, -,Y11. 1. a ., - •
+`.' " i i url aC • •ft . .oL� .• •'._ �` i� ; .,s ,0 F tk -4,14'.il,s -r Fp N. N.I.N K�” '+t' z f� ' r � ! + • r.a 'r •• a � ..�, t�
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t star _, ✓� }t . "t k ti .r f + - cl * 1 74 y
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