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HomeMy WebLinkAbout0015549-Building � f � CITY OF OSHKOSH N°_ 15549 ` PERMIT - APPLICATION AND RECORD TYPE: BLD�HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING � FLOOD PLAIN HEIGHT v - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �� � S I I r t1�� � � PLAN NO. OWNER �V 1—Y—t�'C� /`t'� WlP � DESIGNER USE/NATURE OF WORK � /�t�9�' f\ /pCOP� t�h�flf�'S/l� BUILDING CONTRACTOR ° Size Sq. Ft. � �Z� # Rooms # Stories � Height Foundation Class of Const. � Occupancy Permit J�� HEATING CONTRACTOR Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR � ` /L � Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits t � PIUMBING 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: Valuatio $ � P ' Fee Paid $ T �� Park Dedication ${��� ISSUED BY Date � Final/O.P. �� r� "�v In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE �I � ( �� �� ? AGENT/OWNE DATE 1 � `, � � ADDRESS y v `� TELEPHONE# �-�z-� ��. stateotwisconsin WISCONSIN UNIFORM * Department of Industry, APPLICATION N0. �� LaborB Human Relations BUILDING PERMIT Division of Safety&Buildings Mad s�on,WI 53707 APPLICATION Wisconsin Statutes 101.63,101.73 See/nsf� ons On beCk ol Ink Co PARCEL NO. �E������������ TRUCTURE ❑ HVAC ❑ ELEC ❑ PLUMBING O ner's Na ai g Address Telephone w. '�� `v ' � `— 7 Contractor's Name Mailing Address Telephone ���c F- ��OJEG"��.�CA"1`�i�N ; '/a, '/a,SECTION ,T N,R E or W _. _ _. Building Address Subdiv'�ion Name / Lot No.� Block No. 2� �� 4 � �'- ZoningDistrict LotArea Fron Rear Left � Right � Qc��n. Setbacks �v n. Z3 g' tt. �S n. S` n. : ___ _ ___ _ _ __ _ ______ __ 1a. PROJEGT'` 9. 'f'YP� �. !��.E�'��1tCAL : 9�. Hitl4C�Q1�EIE�M'�N�' 12:' EH�RGY SQL�flCE `` _ _ __ _ _ _ _ ew ❑Addition ❑ Raze ingle Family Entrance Panel orced Air Furnace Fuel Nat. L.P. Oil Elec.Solid lar Alteration ❑Repair ❑ Move ❑Two family Size:�amp Radiant Baseboard or Panel C s * ❑Other Ser �ce: ❑ Heat Pump Space Htg. ❑ ❑ ❑ ❑ ❑ ❑Other nderground ❑ Boiler WaterHtg. ❑ ❑ ❑ ❑ ❑ Overhead entral Air Conditioning �b. �`aA�AGE : > � C�7.�1fE�E 7. :F�3�lr1DA�IC�N>'� Other ' ❑Dwellin unit will have 3 kilowatt or _............. .............. more installed electric space heating equip. it2 cO�St�UCted oncrete 'lE�. PLUI1A�fNC� ' �nfiltration control option is:❑Full sealing ttaChed ❑ DetaChed Masonry Sewer of joints. ❑Blower door test. ❑Exterior , ❑Manufactured air infiltration barrier. '�, ��, ❑Treated Wood unicipal � S 5 S'�!�Ft�ES! ❑otner septic i3.: N�A�'!LO$S;Gafculaiies�) Basements q.ft. Permit No. ❑1-Story � ��� Envelope BTU/HR Living Area��Sq.ft. 2_Story ❑ Seasonal 1f. �����;:i ' Infiltration BTU/HR ther ermanent unici al Utilit 14�> �S71MA'C��I CO3'�'f Garage �� Sq.ft. �� Other P y r Private on-site Well �„_ � $ �"� The applicant agrees to comply with the Wisconsin Uniform Dwelling o and other Municipai Ordinances and with the conditions of this permit;understands that the issuance of the permit creates no leg liability,express or i pli ,on the Department or Municipality;and certifies that all the above information is accurate. � � � � SIGNATURE OF APPLICANT � oArE � � CONDITIONS OF APPROVAL This permit is issu p u t to the following conditions. Failure to comply may result in suspension or revocation of this perm o her penalty. �������. ❑TOWN ❑VILLAGE ITY ❑ COUNTY Municipality Number ot Municipality Number of Dwelling ❑STATE ❑ Iy,DEPEN EN Inspection Authority Location,if different JURI�D�T1�N '; oF: k o ��-�-� -— — — F�S: B�RM�Sj' Vlt[S.ilN�t�RM��RMIT PEAId[I'F ISStJED 8Y: ; ' >FS�U�.._; SEAL NO. �/� Construction Plan Review . . . $ �LL.- � HVAC rti!•t. �� Inspection . . . . $ NAMF ❑ Electrical �!� C � �i� Wis.PermitSeal(s) $ � ❑ Plumbing DATE T ls Other . . . . . . $ ❑ Other .� i/'�,�� TOTAL . . $ CERT.NO. �7� 56D5823(R.04/87) WHITE—IssuingJurisdiction YELLOW—DILHR GREEN—Inspector PINK—Owner/Agent ^��"�r� • ' 1 • ' �AA�i.�w7l�W V�7L �lµ•ii.�,l„l7L� �.r'"3iJ��"W�JL ' I. c�aL _ Bistldiryg P�it # zonis�g cbr�oaoir,q No:rconfn��_ JOb Ia�at3�_ ��� �' �r' oL� ZGt Dims�si+o� � ! Ptopat'ty Owr�����-r-- I`�s-ss�� ?ct �is�es � a. aa�sr�o�� �n . � . D�sa-ibs Wt�c: ��,.1 �� _,•� � -�� �� �A�TZ411 �A�1TRplT� _�r � _� � �ssi�� �Y : _��ocs _D�Patic _Stio�-g�i.LY _Batthoas� _Siga _M�1.ttrFmmily - _Ctility S� Po�th _C�adal �� ��It) _ aI. O�Z�E �S li�et i.. t�s�i r-�.n!► Dl�dC7�.Y/O�t3 �� �� . . � _ w� Y _ �t � rot A=aa `�y� trt t��� . : — � . � � � � ' J� ' _ Ii�at Y�Sd ��, _ 83ds Tasd � l _ S3d� Y�rd Qa � _ ' � � _ Bnild3riq As� � _ tct 11s�a p�r Facdly �� ' _ C1o�z Iot �.. � � �LY� � 19. �.RT� A[T�Y Tt�t Plarirtiag Ddsec�or, az �pzop�iate dasigrus� mat appzov� aLL plari,�, �t tt� �olla+oa�g: (1) 81l�at�,aa�s a� int�+o� work wi�n th� tss� it aoe�o� and � s�o cbar� o� u� is ptopoa�d. (2) � itm. �q:,. ad'd3�s#g. ai�3owa, ' s�c., � th� us� is coato�r�g and � m d� cLR� is pmoQat� � � ao�c e�].i�s aath tht abot+e crit�o�a, ttas pe�a,t dtn b! z�evi�ned bY � Htstldfs�q 2c�c�o� adthomt r�l to � Plas�ais�g Disa�.�bor. � : �AFQPDVID D10T ApPi�VID Plaa �'��;^�+ 14�3�On g�quired vas3ancels) , � . REVg3� HY: DAZ; — — City of Oshkosh 1/1/85+ , . � PARKLAND DEDICATION FEE COLLECTION RECORD Address � � �.�. � Owner's Name �,�ti--��--t� Name of Subdivision �� (�` Lot # � 61 dg. Permi t # ��.�''� /� No. of Units � Fee Required � Fee Paid Q Owner's signature � Date InsF�ector's signature Date Parks ubdi ision � Improvement Accts. Rec. : 362-041 r ~ ,.,hl � ^ ����/ � NA��IE �� A�DRESS `�>'�� � �vNP-cu r�l� LOT � BLOCK 'dARD SUBDIV. ��� I C��"I ZONE STREET N0. ���� (�<`���-�� _�Z�Q LOT D I MENS I ONS SIDEWALK EXISTING YES � NO � BU I LDI NG GRADE ELEVAT I ONS STAKES SET AT S I TE r'�.,� �� � , I 9 P� y BY �. �>^ �� � i , FEE: $1� .Q0 ' �'J DEPARTMENT OF PUBLIC WORKS I , the undersigned, owner or agent of the above d cribed prope ty agree to have the grade established before excavation has commenced - , a S r ���R�_��� . , , a . i , � ,�..,...d,.._...���......�.,�.,,.._,. r i � � z.�' r � � , s .; ; 1 i i � 's e 1 I , /�"6 � ' !� ,� -- -, �------- _ _ ---�---- , �.:... . _-. _. .____ _ -----}--------- __._._________ � _ _ ____.._.______._.__�� � � � � � � � � �- -_._--- � � � __t_�. 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