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Home My WebLink About0008600-Building � .-+i � CITY OF OSHKOSH N° 08600 `' PERMIT - APPLICATION AND RECORD � TYPE: BLD �s HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONINGr� FLOOD PLAIN( '� HEIGHT__C7�"1 - - - - - - - -C�� -�- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - /� � � ; ADDRESS �� ` -s �t� PLAN NO.` " � �� r,, � OWNER � � ''`� c� ��7 fl` f � DESIGNER__ i`-� � ( 7"�l�l `f�''`� USE/NATURE OF WORK � �/ �� cc � ^` �-� Cq--0. tl`c�Q � � � � L� w BUILDING CONTRACTOR r P r� Size� ✓�' Sq. Ft.��O # Rooms Stories Height Foundation B-r.�h� Class of Const.� Occupancy Permit HEATING CONTRACTOR � Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S r ELECTRIC CONTRACTOR � ��v�`,S Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures — Switches Receptacles Circuits PLUMBING CONTRACTOR � —BT WH —Disp WSoft CBasin Lav —Sh DW DF San. Sewer WC FDr SP Ur —Storm Sewer Sink —LTub Eject SS —Water Other FEES: Valuation � � Per ee Paid $ ° � ° Park Dedication $ ISSUED BY Date �n '� Q — �_� Final/O.P. � � —(( —S� � In the performance of this work I agree t erform all work pursuant to rules governing the described const�uction. SIGNATURE •1'� "�� v —� � � ' AGENTiOWNER DATE � �� ADDRESS /'�� 'L'CC� � J �< �G�� TELEPHONE# �� /�-s� - �'� StateofWisco�sin — ' WISCONSIN UNIFORM Department of Industry, Labor 8 Human Relations BUILDING PERMIT APPUCATION NO. Division of Safety&Buildings Mad son,WI 53707 APPLICATION Wisconsin Statutes 101.63,101.73 S e lnstruCtions on baCAr o/ Ink co PARCEL NO. : __..............................................__.........._..__....._.....__....____ __... . ........... ...._._..... _._.. _..... ______ ______...___. ____. ____ ___.......... PERI�:IT RE�i�E$TE� TRUCTURE ❑ HVAC ❑ ELEC ❑ PLUMBING Owner's Name M iling Address Telephone - (f _ u OUS( �a'7� 5 C Contractor's Na e Mai ing Address Telephone ��c� �. ��i,e �- O S � a�-C �� ' �� c�� '/a, '/a,SECTION ,T N,R E or W >: ,. Building Address Subdivi 'on Name t Lot N� Block No. �� • � �� Zoning District t rea Fron R ar Left Right �s .tt. Setbacks `� h. ��! tt. 7� n. �� n. : �a l�ROJ�GT : � 'I'�P� �t .��.��AL. .: 9x ii�`�4C��tl�llF�N1' i�. �N��GY SOL�RC� > _ _ „ ew ❑Addition ❑ Raze Single Family Entranc nel orced Air Furnace Fuel N t. L.P. Oil Elec. lid lar ❑Alteration ❑Repair ❑ Move ❑Two family Size: amp adiant Baseboard or Panel G s • ❑Other er ' e: ❑ Heat Pump ��9• ❑ ❑ ❑ ❑ ❑ ❑Other nderground ❑ Boiler Water Htg. ❑ ❑ ❑ ❑ ❑ ❑Overhead ❑ Central Air Conditioning fi�Y, ��7i� '; � �� . :F�itlblDll►�'ION <: ❑ Other * ❑Dwelling unit will have 3 kilowatt or _... ...: ..__....... ..........:.:. more instailed electric space heating equip. ite constructed oncrete iQ. RLUIIAB[[��i > infiltretion control option is:�Full sealing Attached ❑ Detached Masonry Sewe of joincs. ❑elower door test. ❑Exterior ❑Manufactured !',�, �{��, ❑Treated Wood uniCipal air infiltration barrier. ��J� � ,�,��M�� ❑ otner ❑ septic i3, }#�AT;�,.03b' :Gatc lated} Basements �L�Sq.ft. Permit No. � ,�j^� -Story � �� Envelope Op BTU/HR Living Area_`-��Sq.ft. �2-Story ❑ easonal 7f �� ;. ` : Infiltration �O �,0� BTU/HR Garage c i Sq.ft. �Other Permanent Municipal Utility '�4.;��}E�� > c ❑Other ❑ private on-site Well $ �v The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Municipal Ordinances and with the conditions of this permit;understands that the issuance of the permit creates no legal liability,express or implied,on the Department or Municipality;and certifies that all the above information is accurate. SIGNATURE OF APPLICANT DATE � � COND TIONS OF APPROVAL Thi � 's issued pursuant to the following conditions. Failure to comply may resu�t in suspension or revo tion of this permit or other pena y. /� � � � � � r f l �-- � �, � f � G � �� ( r � l C C•{{1 G�- C f� Q�Z� L°c� � ��.�.��•�► ❑TOWN ❑VILLAGE ITY ❑ COUNTY Municipality N mber of Municip lity Number of Dw ling ❑STATE ❑IN P DE Inspection Authority Location,if different J��13D�T�?�l oF: �'�. '� ��-��S.� - �S B�RM�Sj WtS:'Ut��RMIT P�EUi!!'�1�,St�8Y: �(� onstruction Plan Review . . . $ —�'� � HVAC NAME Inspection . . . . $ ❑ Electrical Wis.Permit Seal(s) $ � ❑ Plumbing DATE �-� �� Other . . . . . . $ ❑ Other `!�� TOTAL . . . $ � � CERT.NO. � � SBD5823(R.04/87) WHITE—IssuingJurisdiction YELLOW—DILHR GREEN—Inspector PINK—Owner/Agent f tl n nr,n :