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HomeMy WebLinkAbout0045102-Building , 1�� � CITY OF OSHKOSH N°- 45102 � PERMIT - APPLI ATI N AND RE RD C O CO TYPE: BLDG [�HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING ,� FLOOD PLAIN HEIGHT „""i - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ; ADDRESS �� v �NL-�-� �� PLAN NO��='13_� � ; OWNER �- ���-� DESIGNER USE/NATURE OF WORK �,..t�UU ��'�CZ� 1 f�`(��L-� � � ITAC�� ���Z��-�. � BUILDING CONTRACTOR �IM�Nsd� ` Size �a-�� S . Ft. ��"�y� # Rooms �-�Q # Stories � Height '� ` Foundation ��'�� Class of Const. � Occupancy Permit F HEATING CONTRACTOR ���C�� � Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S - ELECTRIC CONTRACTOR ���� ` Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps x Fixtures Switches Receptacles Circuits � i i PLUMBING CONTRACTOR l� _BT —WH _Disp —WSoft —CBasin ' _Lav _Sh _DW —DF —San. Sewer r _WC _FDr _SP _Ur —Storm Sewer _Sink —LTub —Eject —SS —Water � Other �. FEES: Valuati n � �� Permit Fee Paid $ C���•�� Park Dedication $ ��Q° � ISSUED BY � Date S` a� L �� Final/O.P. In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE � � � ° � AGENT/OWNER DA ADDRESS ��D �� d � ���-�Z�O � TELEPHONE I � t�3- os� s q� y� � Wisconsin Departmentof Industry, WISCONSIN UNIFORM BUILDING APPlication No. � Labor and Human Relations PERMiT APPLICATION �,S 1.�a Safety and Buildings Division P.O.Box 7969 (See instructions on back of pink copy) Parcel No. Madison,WI 53707 The information you provide ma be used by other govemment agency E Wisc nsin Stat t s 1 1.6 101 J3 pro rams�Privacy Law,s. 15.04�)(m)]. X ' : < -:. , ��RI1��'���u��fi�� (�Constr ❑HvAC ❑Elec ❑Plbg ❑Erosion ❑Other: Owner' Name Mailing Addr ss Telephone No. �lz�� . -�d �y�a �- � Contrador's ame: �Con ❑Elec ❑HVAC ❑Plbg iUCert# Mailing Ad ress Telephone No. .� �uu� 7� rv vt s � (� �3S'-a// Contractor's Name: p Con Elec ❑HVAC ❑Plbg idCert# Mailing Address Telephone No. L� ( ) Contractor's Name: ❑ on Elel�HVAC�'Ibg idCert# Maiting Address Telephone No. V't Ci,�, Con ractor's Name: ❑ on ❑Elec VAC �Plbg LiUCert# Mailing Address Telephone Na � � ) ��������.�. . � Lot Area ; Sq.ft. 1/4, 1/4,Section ,T N,R E(or)W Building Address Subdivision Name Lot No. Block No. � �S 5 Lu6 fa� � Zoning Distritt(s) Zoning Permit No. front Rear Left Right k Setbacks � '` � �� p��ft. ft. ft. �p ft. . ;;:.>:.;:.;.:::;.;:..::.:.....:....:..;...::..:.:.,-..,-:.....;::::.;:.;:;.;:.;:.;:.::.;:.;:.;:<.:;:.:;::.: ;:�:x;::��:���:?::::::;::>::::::>::;:;:€::::::>::::::::::::>`::::>::>:::<::<;::�<?>.:":.:.:: ., ;::;'::;:.;..:;;.; ::: :<: ;:: :::::>::::::>::.";:>:`:..: :;: OCCE)l���i� �. ��.��#'�d�i.�.... ..�:..��f�!C.�. . .EE?!M��`::::>:>:::::>:��::::: . ;:.. . : ... .. ......... .. ... . .... .. .. . ....... ..... ....... ....... Q1� .. ...............'��,...�t�i��.��:.:S�,l€�:::::»�:>::::::>::::::::>::::::::::::>:;;:::::::;:: New ❑Repair Single Family Entrance Pane� Forced Air Furnace Fuel Nat L.P Oil Elec Solid Solar ❑Alteration ❑Raze ❑Two Family Size:�amp Radiant Baseboard or Panel Gas ' ❑Addition ❑Move ❑Garage Service: ❑Heat Pump ❑Other(print): �JJnderground ❑eoiler Space Htg ❑ ❑ ❑ ❑ ❑ � ❑Overhead Central Air Conditioning W Htg ❑ ❑ ❑ � ❑ ❑Other ;..:::: �Other ater e�.:> Ts<'t`�t�£>;:7�:><. . .�i�A�:....: : ❑Dwelling unitwill have 3 kilowatt or � ��S � ��- - �� more installed electric space heating equip. ite Construded g.Concrete � z' Infil r i '>'��i:[:��.'.�1�II�1I�`i><i'�><::zi??:i:>::::.. t at on tontrol o tion is: Full sealin ;: . .. :.. . .::::::::::::,::::::.'Q Manufadured ❑Masonry � .. .::�.. :::.�:::,:::::::.:::..:::.::....... P ❑ 9 of joints. ❑Blower door test. ❑Exterior � '�`>���'�������`> '< >`> ❑Treated Wood Sewer air infiltration barrier. � Munici al h P ;... '; � ::;:::... Ot er <�. � .��`i���''<s?;::;::::z;:: Unfinished Basement Sq.ft ......_ .... ... . . .. ... . � »s»»::>:>:::::::».::::::::.;:.�:.^s::::.;:.:>:;..::::::.::::::.:..:::::...:::::: Se tic >::::>::::::>��.F::::H�17':���::::�?C�E�t��?��>:::<:»::: :.:.::. .:.:..:.:::::::::::::::::.:::. � P ...............................................�.........................�....... 1-Stor ' �:»�°."��::`>?>::»::><::>:�;>>>[: Living Area �Sq.ft. � y � Permit No. Envelope O� BTU/HR ❑2-Story ❑Seasonal - ?'�:�::>::��k'��?;.<;;<;;;;;:;r3»>i:z<?;<>:;? Infiltration BTU/HR Gara e 5 .ft. �Other �Permanent ................... ..............:....:............. 9 Q Munici al Utilrt P �::��a<:::�'�Jt�i>�����. ::"���. ;.:<>>;:>::::;:::>:::>s::::::::>:::z ❑Other � Y ........................................�s.,.���..::...:..::::.:::::::.. �Plus Basement ❑Private On-Site Well $ � €; 4' The applicant agrees to comply with all applicable codes,statutes and ordinances and with the conditions of this permit;understands that the issuance of s the permit creates no legal habifity,express or implied,on the De rt nt or municipality;and certrfies that all the above information is accurate. � � � APPLICANT'S SIGNATURE � DATE SIGNED �.�� f/� � � APPROVAL CONDITIONS This permit is iss d pursuant to the following condiUons. Failure to comply may result in suspension or g revocation of this permrt or other penalty. � s � �NST�. ���� �s,o� �AS� � �� a�o t � � � � � � � � � e � i �. [_ �;������ ❑Town ❑Vlllage City ❑County ❑State of: Municipalrty Number of Dwelling Location: :����������� � � - � � � � > <:::: a::::. . . >:::.:;::::: „r:y , . . �j���yt �r.t ��.y �q �Y�y �y��y ._. 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' Plan Review $ � nstruction � Inspection $ HVAC Name QiK. Wis.Permit Seal $ '?.� ❑Electrical )�-y�J � Other $ ❑ lumbing Date J'r/ �`7!gs # '].� �osion ��Q�� � ��� G Total $ ��-/ ❑ v Cert.No. 1 6 SBD-5823(R.06/94) � ��� WHI�T�E/�-Issuing lurisdiction YELLOW-DILHR GREEN-InspeCtor PINK-Owner/Agent �J� . ( l�i 5 " �.._.�c8\Z� �t�T � R • ' ""_�.__,."'__,...._._.._._ .. - �_.�-_.""` .. . � � , ._.._--- ; - ti ZONING/LAND USE COMPLIANCE CHECKLIST �-- � JOB LOCATION: � t�JNI,.� S.�e Z N I-"� O ING � � PROPERTY OWNER/CONTRACTOR: �L��� � ���5�� � CONSTRUCTION DATA: New Construction Addition Alteration , r TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) n � � l V� Sw6t� �n�t L /�1 r`T'l�tCNc� �Ai,?�� COMPLIANCE CHECKLIST �5�� ���g�� t G,��� --� S�6 -�2 DEFICIENT COMMENTS % � Use � Lot Width � Lot Area � Lot Area Per Family Floodplain Front Yard r x Front Yard Side Street g Rear Yard Side Yards Building Area Parking Standards Off-Street Loading Standards E Vision Clearance Transitional Yard Standards Landscape Standards � � Height ` � Conditions of Approval f : Compliance with P.C. or ` BZA Conditions of Approval � Signage Standards � /� Drainage Plan REVIEW AUTHORITY As per Section 30-5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or ` designee, must approval 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., t when the use is conforming and when no change is proposed. ✓APPROVED DENIED Plan Commission Action Required Variance(s) Requir d REVIEWED BY: � DATE: ✓ z �f � � 4 k : — - - --- - - - - - - -- - ---- ------ - ---- - • , � � � 1 � � 4 � CarE s/�l�� t � Nar�E �A2121I SAL��i ` AOORE55 � LOT S � 8 LCCK r.;��� � SU80 I V. L U�I�C �(��' � ZCNE � � STr�EET N0. ��5�� VIiV(.i4�v� S� � � L�T D I MENS I Gr�S � S I OE1rA LK EX I ST!NG �` YES u0 � � � BUILOIVG G�ADE ELEVATIONS STAKES SET AT SITE , 19 gY � -- �_ � FEF� �15.00 ����-�%��-� �E?ART�"•E`:T OF ��,,c L I C '�VGRK� I , the undersigned. owner or agent of the abcve dascrioeC property agree ro ha��e 'ne grade estaa � ished befvra excavation has commenced. � � r, �� • a..l"^r.� _'� y City Of Oshkosh 1/1/85� PARKLANO DEDICATION FEE COLLECTION RECOP.O Address pSO�� �r�N�Ar�� STe Owner's Name rll9 j�,�� rQ� Name of Subdi vi si on [_(}�:�E �Z.1�t! . Lot � Bldg. ��rmit # `--� Sl�a No. of Units � �� Fee Requ�red ��C�O. � Fee Paid `���- � � Owner's signature Gate �5 S Inspector's signature Oate o��/ � Parks Subdivision improvement nCti�`.5 . E'C2C. : :J�2-�4 i �f v� • / ��/ %"� .. �i, ^ � Q . � /, f � �� .� �� ���� ��� � � ����� � ��=� �!�� s i , ___ _ _____.�.�_� .-------� I - ------ ; 1 ly" :�.� -� -- �� yo '� �� � . � - _ _ � , � /� � � /<�'�s� � . \� . �� � T a� a�J �2 � �� ,�„ i � �� �r � � �' ;J`� +. �--�_---L��----q t�—�--� ta'--fl---f� OS � �{ �,��� � _ ,---- �___ _ - �� � _ _- --� � � ��y . � . � r� .,�s .�,p . 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