HomeMy WebLinkAbout0021769-Building ,
/� . CITY OF OSHKOSH N° 21769
`' ' PERMIT - APPLICATION AND RECORD
TYPE: BLDG � HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING �� FLOOD PLAIN HEIGHT
- - - - - - - - �Z-cp- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ADDRESS � y� �• �� L� PLAN NO.C��IO 3I Z90Y�
OWNER ���/J'�� J'��'2L'i�
DESIGNER
USE/NATURE OF WORK �"�'GZ-tl� � o,����
BUILDING CONTRACTOR DGG�►?!/v t�
� �� , (c�"S
Size 3�2 x 3'� Sq. Ft. �����Sr # Rooms � d # Stories � Height �� �
Foundation [��i - Class of Const. �� Occupancy Permit�
HEATING CONTRACTOR G��
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
l r � �
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBINC 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 $ 3 0�ODO o 0� Permit Fee Paid $ �� S• �'�� Park Dedication $
ISSUED BY_ �,,�;T��c��� Date �z"�/�/9� Final/O.P. (o _� s- �/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER DATE
ADDRESS
TELEPHONE# .
.
Revised: 8/89
` ��� ZONING/LANO USE COMPLIANCE CHECKLIST
, �
JOB LOCATiON: �`Z � (,G� , 72'�,c- ZONING:
PROPERTY OWNER/CONTRACTOR: ���,G�� ,�,��yt-� _��,�-C;c��-t. ,T�y
J
CONSTRUCTION DATA: •�NEW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool , sign, deck, etc.) •
��C.�� f�,[;eaLC�l�-� �G N�'L�'.�
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY/COMMENTS
Use
Lot Width �
Lot Area
Floodplain
Front Yard
Side Street (frart yard)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per Family
Corner Lot
Landscaping
Transitional Yard
Off-Street Loading
Vision Clearance
Height
REVIEW AUTHORITY:
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) ��laintenance 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.
�LAPPROVED DENIED
Plan Commission Action Required
Variance(s) Requi ed
REVIEWED BY: DATE: Z �Q �'
Q S/�3/Z�lc�/?�
State of Wisconsin
Departmentoflndustry, WISCONSIN UNIFORM r� p
LaborBHumanRelations BUILDING PERMIT APPLICATIONaO.�! � !
Division of Safety 8�Buildings
Mad son,w� ��o� APPLICATION �
Wisconsin Statutes 101.63,101.73 See/nstruCt/ons on baCk ol /nk PARCEL NO.
__.._..._...._...___..............._.........___................................................
,............................. . .
PER'I�T>�3� �tE ;::: .. :>:::<::<:::::<:<::<::<::>:<::><:::«:<:>:><: < :
T T RE HVA E P M IN
RUC U C EL C LU B G
❑ ❑ ❑
Owner's Name Mailing Address G� n Telephone�� S^��--03�
� O C/ .�
Contractor's Name Mailing Address Telephone
>:::� . .<`'. .<:: ::;:< ::.'%'.'>:: ° . :<:<:<::<;:;;::;;>.>:;.;:;;;:;;::>;;::::;:_::;;;;;;;
�r::.:;�.,�r�Cr,��:::::«;<;:.:;<;<::;<;<.:<:::::<::::.;:::::::::: , , /.
TI N T N R E r W
�4 �4 SEV 0 �
Build Subdivision Name Lot No. Block No.
�`� �� . ��iri"�-�
Zoning District Lot Area Front Rear Left � Right`
/�- 7� .ft. S@tb8Ck8 °�', ft, '� � ft �/� ft. (/�� ft.
�a�. ��0.��':.. .: . < >.�:';..::: . .'.° :'':" i�::::�LE��I�::;::9.:�1t`�RC:���l�"::: ;;:..��: ����#G'��UR� - ... .. . <
�New ❑Addition ❑ Raze ❑Single Family Entrance Panel Forced Air Furnace Fuel Nat. L.P. Oil Elec. lid lar
Alteration ❑Repair ❑ Move Two family Size:��amp Radiant Baseboard or Panel Gas �
�Other Service: Heat Pump �9• ❑ ❑ ❑ ❑ ❑
❑Other ❑Underground ❑ Boiler Water Htg. ❑ ❑ ❑ ❑ ❑
❑Overhead ❑ Central Air Conditioning
* Dwelling unit will have 3 kilowatt or
�<.< ;,;;;;;;;;,;,;,:<.«::<:�:<�:'�1��'.�.<:���!It��►�`Itkl�>':
Other
�� `� ore installed electric space heating equip.
�::.::::.:::..:. ::::....::.:.... .........:.:.::...:...::::.:::.::.:.:::.::.. :....::..::.............................:..::.::..:
,,,���rrrS�5 ;..:::::...:::.:...................:...:............::.
❑Attached ❑ Detached
,q�,Site Const�uCted �ConC�ete �� .R�;;,{����j i Infiltretion control option is:❑Full sealing
��Manufactured Masonry ggVVe� of joints. ❑Blower door test. ❑Exterior
�. .{��, ❑TreSted Wood � Municipal air infiltretion barrier.
;:.
�
❑Other ❑ Septic 1�.<:�'�'.�:��`Y:,C81�18t `
Basements S ft. '
q �.;.����:::
Permit No.
-� �.�� ❑1-Story ��:<��»»>:>s>s»:_;:_ :>:><::;: Envelope BTU/HR
Livin Area��S .ft.
9 4
n I `:'�:'��>:::����:<:<: «:::<::::<.:«r::<::<::<::::::::<::<::«:::<::: Infiltration BTU/HR
�2-Story ❑Seaso a
Q ❑Other �Permanent ($�Munici al Utili '���::�$������::�$�»::':_>::::>:;:<
Garage Sq.ft. ❑Other P tY
❑ Private on-site Well
$ 8o0rOc�
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 liabiliry,express or implied,on the Department or Municipality;and certifies that all the above information is
accurate.
SIGNATURE OF APPLICANT DATE
CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalry.
�
lL�� z�. I/ �Ll � , l � . 5 �
Z,Z � (33 �
�i • D i) � c+-� �
�3. ad' o P
NTr Munici ali Number of Municipality Number of Dwelling
;:;;:;: ❑TOWN ❑VILLAGE I�CITY ❑ COU P tY
�l�����i<?:::::><:>:s::::>::::::>::>:<:::
<:<:<::«:<:<,::>;»:::<;:<:«:_ >::;:;:;;:: ❑STATE ❑IND PENDENT Inspection Authoriry Location,if different
;;���C�SD�T#±�N`:;[::;:: OF: C� _ 7� �v � _
:..:..:::<.::<.;::.::.::::.:.::. :: .::. �—
- -- -- - --
R ;;;>:>»»::»;>;»<<»<»<;:»»>: >«. <:<::<::<::<<::<><:« <«:;««:<;:««:<:;><::;>:::;>;;<;::;>;><<>> » <:;:;<<::::;<:>:<_:
l��> ;...:......:..... :.:.:::::::.;;:::`:'t+�t3�l+t...�:::;::`.;::ill�:::v�1':R��il.::::.:.
.::::::::<:<..;:..:.:...:.::::::.::::.:.:...__. ._..:...;.;:;.;.>: ;::::::::::;::::..:l���:��:�f1C.........:..:,...__...:....::::............ ............ ..:.. .: .. :;...:.......::;:.::<
'�«:>::>::>::::::<:>::>::»::::::>::::i�9lL:�K#:<::.;>;:;.;;::.;;::;:::::::.;:.::.;:.::.::.::.;:<.:::<.;::::<:<:::::<::::::::::::.;::.:::.;:.:;.::.::.::.;:.;::.;:.;:.;:;::««<.>:.>:;<;<;<<::>:.>:.>:.:<:::.:::>:.:<.:«<::;::>::::::<::«.::.
Plan Review . . $ ��'�O �Construction � �
❑ HVAC ,� 9 �� NAME
Inspection . . . . a � ❑ Electrical a
Wis.Permit Seal(s) S '�''� ❑ Plumbing DATE �' �� �
Other . . . . . . S ❑ Other v�5-s�
TOTAL . . . S � � �,J CERT.NO.
SBD5823(R. ) WHITE-IssuingJurisdiction YELIOW-DILHR GREEN-Inspector PINK-Owner/Agent
�DDB. �p
GATE i Z�� �I�O
, ,
NAME �,�i��C,Q �,�➢ AODRESS ° J
LOT B LCC'rC TddkD
SUBD I'J. ZGNE
STREET NO. �OZ�f- � � CZu�. L�T D I,�IENS I GrdS
SIDEWALK EXISTING YES � NO �
BUILDING GRADE ELcVATI0N5 STAKES SET AT SITE , 19 BY
FEE: $-�-9�60
i�,C,,
I _
��� '
�E?A�T'.'�`,T OF PU3L i C '�IGRK�
I , the undersigned, owner or agent or the aocve descrioec property agree to r,ave the
grade estaaiis�ed bef�ra excavation has cemmenced.
��r'�`7� '
Z � �
_ _ �� •
��/ � i
�a =�_-�
a�� �= � D
� _ �-�
._ _____ ,
;
�
� 1i
�
.
� �
�
u e�� -
��
��� � -
� �0• � $
� . --f � �
'1� �:__ _, �fiz .
I'�'°`� �: ►
; '��1 � i
_ �--�--------- - .-- -.�7'1?____�
as ;
,
�
,
�
i
____ ________..._ ,
_ __ -70. � :
�
�S�� �� ���' ��
.
- , � X ���� ��"
�� �