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HomeMy WebLinkAbout0017575-Building CITY OF OSHKOSH N°_ 17575 PERMIT - APPLICATION AND RECORD TYPE: BLDG _kHTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING r FLOOD PLAIN O"" ` HEIGHT ADDRESS 2--o oc 7mt- : Cate C'- /c c c PLAN NO. i�' a' i OWNER 6 "' L e C--1 ; r (C cn .S('‘' V■ C 5V DESIGNER USE /NATURE OF WORK = ,I - 9 f 1 C' • BUILDING CONTRACTOR (5 Fl Sq. Ft. i' / ?' # ooms 71 Ldh # Stories -- Height (6 Foundation •' -- Class of Const. Occupancy Permit f HEATING CONTRACTOR l/.Z Heat ❑ NC ❑ Vent ❑ Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR ( '- Electric Serv. New 111 Change ❑ Temp ❑ Type Volts Amps Fixtures — Switches Receptacles Circuits PLUMBING CONTRACTOR a.. l BT WH Disp WSoft CBasin Lav Sh DW DF San. Sewer WC FDr SP Ur Storm Sewer Sink LTub Eject SS Water Other FEES: Valuatio 4 " 11 0 ? 67 / dS0 Pe 4t Fee Paid $ Park Dedication $ ! ISSUED BY / ...� , - Date r Final /O.P. /- IJ 7 In the performance • his work • ee o •erform work pursuant to rules governing the described construction. f SIGNATURE / -e-7 ' _ _� ENT/0 , • / . ATE ' 41 V46 i ADDRESS 4 : 7 . .cf/ 21 TELEPHONE ?--- IZ- .- ?o(,- State Department Wisconsin of Industry, WISCONSIN UNIFORM Depart Ind -•-� Labor Human Relations Division n of S afety � Buildings BUILDING PERMIT APPLICATION NO. /7S ( S S Box Madison, Mad n, WI 53707 APPLICATION Wisconsin Statutes 101. 63, 101.73 See Instructions on back of pink copy) PARCEL NO. PERMIT RE# UE�O L_I STRUCTURE 1 HVAC El ELEC ELEC I I PLUMBING Owner's Name Mailing Address Telephone z4Nap ?i,.,0 te le.t6.-eopr-4e , 3 I- 6 __.5" CoAl[ractor's Name Mailing Address Telephone ................................................................................ ............................... ................................................................................. ............................... ................................................................................ ............................... ................................................................................. ............................... ................................................................................ ............................... '/a, %, SECTION , T N, R E (or)W Building Address Subdivision Name Lot No. Block No. `}Os 7 ii0A4 —e hi r— P q/C e 7 Zoning District Lot Area Front Rear Left Right f '-OC7 sq. ft. Setbacks ft. „. ft. n. 44:::::::: P OJ CT 11-::::: TYPE II. :ELECIN#CA#.::: 9x // V`AC ::Etli )IPMENT 13.' ENERGYSO lRCE lew ❑ Addition ❑ Raze S ingle Family EntrapggPa� ��rorced Air Furnace Fuel t. L.P. Oil Elec. Solid Solar * ❑Alteration Repair Move ❑ Two family Size �•(' amp ❑❑ Baseboard or Panel s El ❑ Other ,SSeryice: ❑ Heat Pump Space Htg. ❑ ❑ ❑ El ❑ ❑ Other {g' Underground ❑ Boiler Water Htg. El ❑ ❑ ❑ ❑ ❑ Overhead ❑ Central Air Conditioning Ib aARAGE : % 4 CONST TYPE 7 FOW]NDATION ❑ Other * ❑ Dwellin unit will have 3 kilowatt or .[� more installed electric space heating equip. ttached ❑ Detached �"2Oite constructed •+,‹oncrete 1 P 13R 1 Infiltration control option is: ['Full sealing ❑ Manufactured LJ lvfasonry of joints. ❑Blower door test. El Exterior AR CI Treated Wood ewer unicipal air infiltration barrier. f1 �P S q. ft. S' El Other El Septic 13. HEAT LOSS Calculated} Basements _ DRIES ; PermltNo G3— ba / � ;:.�`gE Envelope BTU /HR Living Area r �� Sq. ft. Story CI Seasonal 11 WATER ; Infiltration 2 BTU /HR Garage 4 -4 Sq. ft. ❑ Other ermanent unicipal Utility 14 STIMATED COSH Other Private on -site Well $ 8© The applicant agrees to comply with the Wisc. sin Unif• D -Ili r. • • - . - :: • - r nicipal Ordinances and with the conditions of this permit; understands that the issuance of the permit creates no I. !al liab —, , y •res or mpl d, on • - ■epartment or Municipality; and certifies that a he above information is accurate. / /, SIGNATURE OF APPLICAN A 2 A __ DATE % .� CONDITIONS OF APPROVAL This permit ist issued p rsuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty 9i) akt / . j/- `777- -(..)-.. 5 p In .I4- p v"'"" (t r- 9` 6 r-t `r c _ y L's !� /7/�. —C/ / e. r` c�J. ` f-+G v� C 4 r cvf' ' C 3+6'•- r.....e- Yo , ,Ce SiaGc M P Q P`aeG� ISSWI El TOWN ❑ VILLAGE CITY ❑ COUNTY Municipality Number of Municipality Number of Dwelling I ❑ STATE ❑ INDEP E Inspection Authority Location, if different RISDICT N : OF ,� S e l 7 Q- !2 �v _ S PE f$} : IAiI&. iltlt EIE;M Il»RM1T PERNII 1 155 131E Plan Review $ </� Construction HHVAC NAME I l't ti- k4 e Inspection . . . . $ ❑ Electrical Wis. PermitSeal(s) $ '3 ❑ Plumbing DATE r I Other $ ❑ Other TOTAL . . . $ - 7 •Y/ ( 7 / CERT. NO. 'I - , /. 0 SBD 5823 (R. 04/87) WHITE — Issuing Jurisdiction YELLOW— DILHR GREEN — Inspector PINK —Owner /Agent 6 Poo 6 e-- Se Remised: 8/89 ZONING /LAND USE COMPLIANCE CHECKLIST JOB LOCATION: 700 /2( „j-0 ice' ZONING: PROPERTY OWNER /CONTRACTOR: CONSTRUCTION DATA: ANEW CONSTRUCTION ADDITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, poo , sign, deck, etc.) /Jet COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT DEFICIENCY /COMMENTS Use 1- Lot Width Lot Area ,v/ `' Floodplain Front Yard Side Street (front yard) Rear Yard Side Yard (R) Side Yard (L) Parking Spaces L ; Building Area Lot Area Per Family Corner Lot Landscaping Transitional Yard Off- Street Loading Vision Clearance C— Height REVIEW AUTHORITY: C/ 4r /- -c__ 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. APPROVED DENIED Plan Commission Action Required Variance(s) Required (:- REVIEWED BY: f , / .. , ,�� % DATE : " YC) i H d O k U1 .i t Y ° 'Z J E. , U1 C 3 H cn r4 o I P ® H c h to 1•- tNt U p Z Z O il:i, , 0 --. U to r=4 • La O Z 1 N x o 1 - as U u C' -P o cn P4 3 w -I U w ,. Z • A • (n < rz o ' iii J • W Y W ; i • P r 1— � w -- Q H Lil 0 13 ' H 1 S • 4 (n '" ,, ' cc A •--• w ) , ' C7 O (.1) 0 IA < co _J ;._•, 4 , , - v J Lu W; w , J ti It W W , , , \)____. , . . t, ; W ii G a< l < r 1 > ^ W . p N a \ IF i }3 i 3 .. 7 f� 1 . — E f W 4 d. , s VVVV ; I .. 1'4 il w w w w w s ' . _ V ri 1 S ie: i 0 ,� City of Oshkosh 1 /1 /P5 PARKLAND DEDICATION FEE COLLECTION RECORD Address ' C �� c r Owner's Name (=;- c ..- 6 a \s 5 e Name of Subdivision f. (11(LCA1,-"e- Lot # Bldg. Permit # / 7 No. of Units r Fee Required /CO Fee Paid 4011 Owner's signature , A� Date Inspector's signature j/. /t,_ Altar Date ff — Ili Parks Subdivision Improvement Accts. Rec.: 362 -041