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HomeMy WebLinkAbout0010896-Building CITY OF OSHKOSH N2 10896 L PERMIT - APPLICATION AND RECORD TYPE: BLDG HTG ❑ ELEC ❑ PL BG ❑ SI GN ❑ ZO NING Z" \ FLOOD PLAIN HEIGHT ' i .c/ ADDRESS L n ..--g-- C' �Q (‘ / C� e - PLA NC � " / /o861 OWNER C7P.hP0+ c.9 -..'- �I'��vG���c . DESIGNER USE /NATURE OF WORK /F? c.c> Yr Imo- w AV --- fr" BUILDING CONTRACTOR �CA-}` fit. t f Sizp - t` 4 ?-, Sq. Ft. ` 57C7 # Rooms 0 I 4 # Stories ( Height Foundation Class of Const. 8 Occupancy Permit r? -e HEATING CONTRACTOR 4-14 -r- Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S 1 ELECTRIC CONTRACTOR ' A■. i Electric Serv. New ❑ Change ❑ Te ihp ❑L Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR vl P -(_, BT WH Disp WSoft CBasin Lam Sh DW DF San. Sewer WC FDr SP Ur Storm Sewer Sink LTub Eject SS Water Other FEES: Valuation $ L��.lr 1�� 1 Per '' Fee Paid $ r ( 0 Park Dedication $ (0-0 ISSUED BY /� / /.. i »��L /_ l% Date l - 1 -(5 Final /O.P. "7 / - )? In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATU �� - .• � __Orli Di AGENT /OWNER DATE ADDRESS TELEPHONE # -� " 3 - t 21 -low State of Departme Ind WISCONSIN UNIFORM Department of Industry, Labors Human Relations BUILDING PERMIT APPLICATION NO. /0 VC pp cp Division of Safety 8 Buildings Box 79 Madison, WI 53707 APPLICATION Wisconsin Statutes 101. 63, 101.73 See Instructions on back of pink copy) PARCEL NO. PERMIT R EQUESTED STRUCTURE El HVAC El ELEC 111 PLUMBING Owner 'sN :.::::::::.........: Mailing Address Telephone er to 5 0,1-. 7 Go r' .,Q Contractor's Name Mailing Address Telephone e t L fi _e-(' ................................................................................ ............................... RO I*CT C N '' /a, %, SECTION , T N, R E (or)W Building Address diivision Name ` /� Lot Block No. 2 ` s r /Q e r Gras i4 It �-(.(t SC / ,1 I Zoning District Lot Area Fron Rear t Left — Right 1 ( [ Z 0 v. ' Sq. ft. Setbacks ft. ft i Z -S ft. / 7 �� ft. 1: PROJECT ; 3 ; 1' t'PE :; B : ELECTR. AL Sx: FIVAC EQL lPlietif 12 : ENERGY SOURCE .ew ❑ Addition ❑ Raze fN4ingle Family Entrancs,Panel rced Air Furnace Fuel Nat. L.P. Oil Elec. SolidSolar ❑Alteration ❑ Repair ❑ Move CI Two family Size: � amp Radiant Baseboard or Panel G s * CI Other Service: CI Heat Pump Space Htg. f=1 ❑ ❑ ❑ ❑ ❑Other underground ❑ Boiler WaterHtg. ❑ ❑ ❑ ❑ ❑ ❑ O verhead ❑ Central Air Conditioning b GARAGE : ;TYPE. , FOUNDA ON : ❑ Other * ❑ Dwellin unit will have 3 kilowatt or more installed electric space heating equip. ,,��.,// ❑ Site constructed ❑ Concrete 1 ❑ Manufactured PLUMBIING ;; ;; Infiltration control option tion is: ❑ Full sealing J�SAttached ❑Detached CI Masonry M Sw er of joints. Blower door test. ❑ Exterior ;:2 AREA is CI Wood �.Municipal is air infiltration barrier. Basements q r S : : ❑ Other L7'Septic 13 .;<REAT LOSS ( Calculated# . ft. _,S_,/S�ORIES. 5 U gQ g1 -Story SE Permit No. Envelope <. 5 CO J BTU /HR Living Area t� Sq. ft. 2 -Story ❑ Seasonal 11 ;:WATER : Infiltration 5'S BTU /HR Garage 7(0 Sq. ft. ❑ Other Permanent Municipal Utility 14 _ESTIMATED COST ❑ Other Private on -site Well The applicant agrees to comply with the Wisconsin Uniform Dwelling Co -- .ther Municipal Ordinances and with the conditions of this permit; understands b' that the issuance of the permit creates no Ie.al 'a - .r�. or i •.r . the P - pa .. - nt or Municipality; and certifies that all the above information is it ' accurate. 1��� SIGNATURE OF APPLICAN I _ r� - DATE CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this rmit or other penalty. �` r V �• 1 w Tt# W /r, of .. 0`-t 1- - rYS 1D 1-YLe_1144 lob ..................... ............................... CI TOWN CI VILLAGE CITY ❑ COUNTY Municipality Number of Municipality Number of Dwelling SS I I=1 STATE g Inspection Authority Location, if di STA IN E h PEND EN spection A thority n, different i ' URI CT N _ :: OF: !.-0 70 _ k. � G - - - - - - S . PE fS : YIt.1 i.. ilr. R m PE „, .. R M Pt El t'( ISS1 BY 40 �onstruction Plan Review . $ L� HVAC NAME fi4 i'l- Dit 4 — Pt— Inspection . . . . $ ❑ Electrical / Wis.PermitSeal(s) $ Q / ❑ Plumbing DATE 0 —Ai —S Other $ ^ ❑ Other / ' j..f. (/ti TOTAL . . . $ 70 6 6 7 9 Z CERT. NO. ll cc..// SBD 5823 (R. 04/87) WHITE — Issuing Jurisdiction YELLOW— DILHR GREEN — Inspector PINK — Owner/Agent At 0000 ZONIM /LAND USE COr'PLZArIE =LIST LIST I. CEIi11AL Building Permit # Zoning 7- ° C:onfoanirg Non - Conforming mil✓ cb Location i 0_5 e Lot Dimension Ply Owner 6 Lot Area a. orrrIa DATA Describe : AJe r' 2-1)c �1 NEW xzION _ ADDITION ALTERAI7CH Accessory 13uilding — Pool .(Si gle Family Fence Deck/Patio — Ttaa- Family Boathouse _ Sign — Ms1.ti.amily 'Utility Structure Pore Ocenercia.1 Other (specify) — Manufacturing III. 03MPLIANCE CBE= ConoLies Deficient Deficienc.v /Oddments Use Lot Width — Lot Area Floodplain • Front Yard Rear Yard z — Side Yard (R) Side Yard (L) - Parking Building Area - Zest Area Per Family Corner Lot Other ( 5t) 1 OC) _ � i f • IV. REVIEW AUTHORITY • The Planning Director, or appropriate designee, must approve all plans, except the following: (1) Alterations or interior work when the use is conforming and when no change of use is proposed. (2) Maintenance items, e.g: siding. wind, • etc., when the use is conforming and when no change of use is proposed. Instances where work applies with the above criteria, the perm t can tia reviewed by the wilding Inspector without referral to the Planning DIrector. APPROVED NOT APPROVED Plan Commission Action Required Variance (s) Raaui.r= REVIENIE D BY: OAT= . . / :ATE f r --1- S E NAME l7 ,,,_ ADDRESS , LO Z ( BLOCK WARD �� /, /# SUBDIV. t-o ( ZONE STREET NO. °2 rt A v 4- s r LOT DIMENSIONS SIDEWALK EXISTING YES [1 NO BUILDING GRADE ELEVATIONS STAKES SET AT SITE (: ,19 &Cr BY FEE: $10.01. /7; 4 DEPARTMENT OF PUBLIC WORKS I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commen -d. Al A dilib i k vir .A/AA 03889 . 6 City Of Oshkosh 1/1/85 PARKLAND DEDICATION FEE COLLECTION RECORD Address ?87R" -?- " C* Owner's Name C;64 I Name of Subdivision 7-r : ( P /el" Lot # c... Bldg. 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