HomeMy WebLinkAbout0048190-Building 110
CITY OF OSHKOSH N2 48190
PERMIT - APPLICATION AND RECORD
TYPE: BLDG [TG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING KJ_ FLOOD PLAIN MA' HEIGHT sz__
ADDRESS 9. 0ov 11' CJ PLAN NO. I\ -14- ilk
OWNER Rv Sc ' L GOnA.
DESIGNER
USE /NATURE OF WORK S
BUILDING CONTRACTOR
Size Ct t Sq. Ft. k").'3- , -09 # Rooms # Stories I (-Ode Height a a
Foundation J ew) f c - Class of Const. Occupancy Permit ICe V i tea
HEATING CONTRACTOR ° RC cam, e.<
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR C ✓,.... , ,, 3 ‹.
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR S 2r k
WH Dis — WSoft CBasin
— Lay Sh DW DF — San. Sewer
— WC FDr — SP — Ur _Storm Sewer
_Sink LTub Eject SS — Water
Other
/� 08
FEES: Valuation $ 11 X000 Permit Fee Paid $ l Park Dedication $ /00
ISSUED BY 199.1 Date 11— l Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ////42 rr —
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations BUILDING PERMIT 1 8 (qo
Safety and Buildings Division 1
P.Q. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
Wisconsin Statutes 101 -63, 101.73 (See instructions on back of pink copy)
<: :;::>: >;» » :: >:: >:: >:<:i::E Constr El HVAC ❑ Elec ❑ Plbg Erosion ❑ Other:
.... ..................... ........................ N (include area code
Q .... 's Name Mailing Address Tele hone o )
Contractor's Name Mailing Address Telephone No. (include area code)
. :
PR. . >rLO: > .. "ION » »
<. <::; <;; ^;;; «;: Sq. ft. 1/4, 1/4, Section T N, R E (or) W
Building Address Su 4 1 4 , f d./ vin Na � ,l _ Lot No. Block No.
p 8 c 010.1 +axe. c p l� � . 1
Zoning District(s) 1 Zoning Permit No. Fron 6 . t Rear c Left Right
Setbacks ft O ft. 13 ft. 1 ft.
i...;: ailat3>: ;;,;;; > :;. ; :. : :.; :. . . . i ..FAN.Y. >:::::<t::> . itAe::E i.it?!IiiitIit#'..ittilEtt Y. SoiEtt .. ...........................
L' ew ❑ Repair ,i Single Family Entrance Panel C orced Air Furnace Fuel Nat. L. P. Oil Elec. Solid Solar
❑ Alteration ❑ Raze ❑ Two Family Size: 100 amp ❑ Radiant Baseboard or Panel Gas *
❑ Addition ❑ Move ❑ Garage Service: ❑ Heat Pump Space Htg ❑ ❑ ❑ ❑ ❑
❑ Other (print): [t�'(er ❑
❑Ove round ❑ Cent al Air Conditioning Water Htg ❑ ❑ ❑ ❑ ❑ ❑
❑ Other :. 0 Other * 0 Dwelling unit will have 3 kilowatt or
ite Constructed oncrete
more installed electric space heating equip
control tin is: Full sealing
E '��� >REU�SASifs<`'' infiltration o 0 ❑
Manufactured Masonry :::::::.:.:.::::. :•:::.:.: optio 9
. . ❑ ❑ Y of joints. ❑ Blower door test. ❑ Exterior
; A 4Ii `E »< > ' >: >` Tr eated Wood
❑ Sew
n un
i ci al air infiltration barrier.
n >:.:: > ORI .:.: >` : : >: > >`::<< Oth P . ... :: ........ : >;sk »•;:: <;:.:;;:.; .<::
Unfinished Basement1188 Sq. ft ..... . .. ............... ............. . ❑ ... ::. ::::::::::.::::: i: : i. Se tic : :Mi - iff iLOS':�J::::: CAtt Aced : :: >:::: >:::
t ��� ❑ Story :a : SE:::<::: »<:s :: Permit No. Envelope -5 BTU /HR
Living Area ! Sq. ft. ❑ 2-Story ❑ S ysonal
ermanent
`'11 ATE' ?^'<` >`<: » ':`� Infiltration 14 9 (e' BTU /HR
Garage �0�1 ft_ ''.i
S
q i I ili
9 n ic a Ut t
u
� (i.�/� El Other P Y '1?t: 0 .:.:..:.::.:..:: ...:::::.......:..:....:....::
❑ Plus Basement ❑ Private On -Site Well $ - oce
The applicant agrees to comply with all applicable codes, statutes and . • ances and with the conditions of this permit; understandsthat the issuance of
the permit creates no legal liability, express or im - part 0 r m nicipality; and certifies that all the above informat is ccurate.
APPLICANT'S SIGNATURE C. .. -- ........d......._ DATE SIGNED /I
PPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may resu in suspension or
revoca of th is permi othe penalty
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e.peDC bc%cc\ o c- r■R. •e? .--,.., r b u w.• ,"\ S1..r,10
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ate cR,�1 V t .,k,\.xb t,.., .-c r_lt aa. (∎Qra
Town Village iit Count State of: Municipality Number f Dw Dwelling Location:
❑ ❑ 9 L Y ❑ Y ❑ o o e g ca o n:
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s1� cis
:::�,.. :::::::::::::::::: ::::::::::::::::::: :::::::: :::::::::::::::::::
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..........................; ..:....:.:............ ............................... ....... : . . ........... . .. .. .. :.: ..... ✓::4 �............... .. J11R�M�. ��IRM. iw��lf. i. ::. i} iii} iii i ?iii ?i } iTiiiiiii ?i }ii
::� *� �D:: :�::�L�.iL::�N :?x.ss: . >:t•:+. .i:::.2: .. .;•.:•;i :•i::o:ci:>:: �:::;:•» ii: o:; s:<• a >;:<�i;r:>i:;or.;•i::•::i:: <•i ; :•:: { c«•: : a:: tt;•>:c:• isa:;•::• i:•:• :•:::i: ?•::a:•::;:•:•:::>::::
Plan Review $ 1 10 onstruction
Inspection $ ❑ HVAC Name /A A IL 4 __ .
Wis. Permit Seal $ '3) ❑ Electrical
Other $ 0 Plumbing /' Date 1I — cr 9-^1 -
1
erosion Total / ?� C9 �L
Total $ V ❑ b Ce rt. No.
SBD -5823 (R.07/92) WHITE - Issuing Jurisdiction YELLOW - DILHR ., GREEN - Inspector PINK - Owner /Agent
/L?,4?5
CATE c � y O
NAME �S�, C
ADDRESS
LOT -4 •
8 LCCK '•
Abo u -pp F-0 y- C.M -R.g_ a &D
SU801V. < ZONE
STREET NO. 2 i » »S +LI ti, r,e LOT DIMENSIONS
SIDEWALK EXISTING YES El NO [::1
B U I L D I N G GRADE ELEVATIONS STAKES SET AT SITE 10' I t 19 EY 411,-
F EE: $15.00
DEPARTMENT OF FULet7 WCRKS
1, the undersigned, owner or agent of the above describeC properr•1 agree ro have the
grade estaaiished before excavation has commenced.
7202 Sa5
S1:
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address g.8 C,► y1/9
Owner's Name RJ 5 c-L,
Name of Subdivision �- {� �,� - {� co",
Lot # Bldg. Permit # C)
No. of Units r
Fee Required k 0 0
Fee Paid k CD1D
Owner's signature i,-- Date i1 Ic1 qc
Inspector's signature 01/Y Date //-1 — s
Parks Subdivision
Improvement
Accts. Rec.. 362-041
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