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Home My WebLink About0145578-Building (sign) 10 CITY OF OSHKOSH No 145578 OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 300 302 STATE ST Owner KIECKHAFER REV TRUST H A/P D Create Date 04/21/2011 Designer Ellen Dedow Contractor TENANT Category 254 - Signs Plan Type 0 Building • Sign 0 Canopy 0 Fence 0 Raze Zoning C3 DO Class of Const: Size 21 sf each Unfinished /Basement Sq. Ft. Rooms Height Ft. ❑ Projection Finished /Living Sq. Ft. Bedrooms Stories Canopies Garage Sq. Ft. Baths Signs 2 Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other 0 Concrete Block 0 Post 0 Treated Wood Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit Park Dedication # Dwelling Units 0 # Structures 0 Use /Nature COMM (300) / Install two new non - illuminated wall signs (one fronting State Street & one fronting Waugoo Avenue) for "Elle Mae ". of Work (Tenant doing the work per signed affidavit) HVAC Contractor Plumbing Contractor Electric Contractor Fees: Valuation $1,000.00 Plan Approval $0.00 Permit Fee Paid $25.00 Park Dedication $0.00 Issued By: Date 04/21/2011 Final /O.P. 00 /00 /0000 ❑ Permit Voided Parcel Id # 0200640000 In the performance of this work I agree to perform all work pursuant to rules governing the described construction. While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement holder(s) and to secure any necessary approvals before starting such activity. I have read and understand the afore mentioned information. Signature Date Agent/Owner Address OSHKOSH WI 54901 - 0000 Telephone Number To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may continue if the inspection is not performed within two business days from the time the project is ready. City of Oshkosh Division of Inspection Services 215 Church Avenue PO Box 1130 /-� J ��/ Oshkosh WI 54903 -1130 �J tHKC. H Office (920) 236 -5050 ON THE WATER Fax (920) 236 -5084 Web: www.ci.oshkoch.wi.us AFFIDAVIT FOR PERMIT (Owner Occupied Property) State of Wisconsin, County of Winnebago, City of Oshkosh ' 7�e, nt� , L. ec/o 4.) , hereby swear and affirm under oath that: (print name) I am the owner of the property listed below, I do currently personally occupy the property and I will self - perform the work. And do hereby submit an application for a permit pursuant to the Wisconsin Department of Commerce Licensing Act 28 (ss101.147), that does not require me to be licensed by the State of Wisconsin, to perform this work at: S .fie S t Cash /kos4 wJ s Y97 / STREET ADDRESS (THE "PREMISES ") CITY STATE ZIP I UNDERSTAND AND WILL ABIDE BY THE FOLLOWING STIPULATIONS: 1. That I will be personally doing the work as set forth in the Permit Application and no contractor for hire will be performing any work at the Premises. 2. I understand and acknowledge that if any person other than me is determined to be performing work upon the Premises a STOP WORK order may be issued. 3. I understand and acknowledge that if I am unable to complete the work at the Premises I must hire a Wisconsin State Licensed Contractor to complete the work and obtain a permit for the remainder of work to be done. 4. I understand and acknowledge that all work must be performed in strict conformance with all applicable building and zoning codes adopted by the City of Oshkosh. 5. I understand and acknowledge that all work performed will be subject to inspection by the City of Oshkosh. 6. I agree to take full responsibility for all work completed upon and the conditions of the Premises. 7. I am certifying the above under oath and am subject to laws for perjury for any untruthful statements made herein and understand that the permit may be revoked for false statement or misrepresentation as to the material fact in the application on which the permit was based. UPON SUBMISSION, THIS AFFIDAVIT BECOMES PART OF THE ACTUAL PERMIT. YI be0 � be6f4e.,) PRINTED NAME OF APPLICANT SIGNATURE OF APPLICANT WO 7C1 0,5k/e 5 V9e/ STREET ADDRESS OF APPLICANT CITY STATE ZIP HOME PHONE NUMBER $'3 3 -0240.3 ONE NU Sr SWORN and SUBSCRIBED to before me this � day of ` i r'i 20 /1 at Oshkosh, County of Winnebago, and State of Wisconsin. ‘041/it NOTARY SEAL HERE NOTARY PUBLIC wan. AP. 04'16'0 ZONING /LAND USE COMPLIANCE CHECKLIST OSHKOSH ON THE WATER Name KIECKHAFER REV TRUST H A/P D Address 300 302 STATE ST Create Date 4/21/2011 Construction Data • New Construction 0 Addition 0 Alteration Type of Construction (i.e. fence, pool, parking lot, sign, etc. 2 new wall signs for "Elle Mae" Compliance `Checklist Deficient Comments HI Use •, J Lot Width L Lot Area HI Lot Area Per Family L_1 Flood Plain J Front Yard Q Front Yard Side Street Li Rear Yard 1___1 Side Yard u Building Area Parking Standards u Off - Street Loading Standards u Vision Clearance J Transitional Yard Standards Landscape Standards 1 Height U Conditions of Approval ▪ Compliance with P.C. or BZA Conditions of Approve Signage Standards Complies w/ 30 -27 (D)(6) Ill Plan - Storm Drainage - City Easements Review Authority As per Section 30 -5 Enforcement of the City Zoning Ordinance, 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. Approved 0 Denied Li Plan Commission Action Required j LjVariance(s) Required Reviewed By Todd Muehrer _ _ _ Date 04/21/2011 City of Oshkosh Inspection Services Division P Boh 1130 Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 _ �� Fax: (920) 236 - 5084 ` ( - f Building Permit Application ON THE WATER If you are a contractor participatingin the Permit Fee Account System and have adequate funds, check here if you want this processed through your account f JOB ADDRESS 200 AA> S OWNER I le,v1 t q)go -,2-03- 426 7 CONTRACTOR i c 3.4 1.13-04^... / 7 v s_ I am the: 'Owner OR ❑ Contractor USE CATEGORY ❑Single Family ❑Duplex ❑Multi - Family ❑Rental Eommercial ❑Industrial Work being done: ❑ Addition ❑ Deck/Porch/Patio ❑ Driveway/Parking ❑ External Remodeling ❑ Fence/Hedge/Kennel ❑ Garage/Utility Structure ❑ Handicap Ramp ❑ Hot Tub /Spa ❑ Internal Remodeling *ign/Canopy /Awning ❑ Stair/Handrail ❑ Stove/Fireplace c-3 ❑ Swimming Pool ❑ Wrecking Permit ❑ Other Additional information, such as plan submittal and approval, may be required before issuance. Fliers, located in the hallway, may be referenced to note if any additional information is necessary. ❖ Full description of work being done: . �. S Ste. S o— ev—r, A.)n (att.() 3 'X 7 l `'w;d `iah - Av Ali </la c/ Any work not included in this application is not permitted. Value of the job $ /420r) (Value for materials and labor is required to ensure consistency in accessing permit fees for all applicants.) PLEASE READ, SIGN, & DATE: I certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits to be obtained. I acknowledge and agree to these terms. 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