HomeMy WebLinkAbout0101936-BuildingOSHKOSH
ON THE WATER
Job Address 4405 ISLAND ViEW DR
Designer
CITY OF OSHKOSH
BUILDING PERMIT - APPLICATION AND RECORD
Owner NICK & ELIZABETH YOBLONSKI Create Date
Contractor L & R CONSTRUCTION SERVICES LLC
No 0101936
06/02/2003
Category 110 - New Single Family
Type · Building (~ Sign (~ Canopy ~) Fence
Zoning R-1 Class of Const: 8
Unfinished/Basement 858 Sq. Ft. Rooms 5 Height
Finished/Living 1678 Sq. Ft. Bedrooms 3 Stories 2
Garage 744 Sq. Ft. Baths 3
Foundation · Poured Concrete (~ Floating Slob (~) Pier (~ Other
O Concrete Block (~ Post (~ Treated Wood
Occupancy Permit Required Flood Plain NO
Park Dedication Required # Dwelling Units 1
Plan E1-070-0503R
O Raze i
30 Ft.
Size IRR
[] Projection J
Canopies 0
Signs 0
Height Permit Not Required
# Structures 1
Use/Nature 4SFPJ 2 story home w~th a 3 car attached garage, concrete dnveway (24 ma . at the lot line) NO DECK OR PATIO·
of Work
MERWIN OIL CO INC
$75.00 Permit Fee Paid
[] Permit Voided
HVAC Contractor
Electric Contractor TOM SCHOMMER ELECTRIC INC
Fees: Valuation $144,050.00 Plan Approval
Issued By:
Plumbing Contractor AHERN-GROSS INC.
$515.00 Park Dedication $100.00
Date 06/04/2003 Final/O.P. 00/00/0000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature ~ ~.~.¢~/. ~'~ ~/Z~'~.Z~' Date
Agent/Owner
Address 28 W PIONEER RD FOND DU LAC WI 54935 - 0000 Telephone Number
923-3698
OSHKOSH
ON THE WATER
Job Address
Name
Address
Subdivision
Building Permit Number
Number of Dwelling Units
Fee Required
Owner's Signature
Inspector's Signature
PARKLAND DEDICATION FEE COLLECTION RECORD
4405 ISLAND VIEW DR
NICK & ELIZABETH YOBLONSKI
0101936
1
$100.00
Oshkosh
Lot
Date 06/04/2003
WI 54901
Number of Structures
Fee Paid
Date ~ _ z~_ ~.~
Date
Wisconsin Depa?ment of Industry,
Labor and Human Relations
'Safety and Buildings Division
P.O. Box 2509
Madison, WI 5370%2509
Wisconsin Statues 101.63, 101.73
[] Constr
Owner's Name
NICK & ELIZABETH YOBLONSKI
Contractor:~ Con[~ Elec[]
L & R CONSTRUCTION SERVICES LLC
Contractor:
TOM SCHOMMER ELECTRIC INC
Contractor:
'vlERWIN OIL CO INC
Contractor:~ Con
AHERN-GROSS INC.
Building Address
4405 ISLAND VIEW DR
Zoning District(s) Permit No.
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
JApplication No.
~36
[] HVAC [] Elec [] Plbg [] Erosion [] Other:
Mailing Address
Oshkceh WI 54901 - 0000
Lic/Cert # Mailing Address
28W PIONEER RD FOND DU LACWI 54935 - 0
Mailing Address
303 HILL ROAD ROSENDALE WI 54974 - 9764
Mailing Address
P O BOX 68 FOND DU LAC WI 54936 - 68
I/4,
Mailing Address
MAIN ST
FOND DU LAC Wi 54935
1/4,Section ,T
Telephone No.
233-1870
Telephone No.
923-3698
Telephone No.
920-872-5055
Telephone No,
920-929-6100
Telephone NO.
-0 ~20-921-1414
N,R E(or)~
Subdivision Name Lot No. Block No.
Front Rear Left
Right
New [] Repair Single Family Entrance Panel
[] Alteration [] Raze Two Family Size:
Garage Service:
[] Addition [] Move Other (print): [] Overhead
[] Other: Underground
Site Constructed Concrete
Manufactured Masonry
Treated Wood
Basement 858 Sq. ft.
I Area 1678 Sq. ft. 1-Story
Garage 744 Sq. ft.
Forced Air Furnace
Radiant Baseboard or Panel
Heat Pump
Boiler
Central Air Conditioning
Sewer
~ Municipal
~ Septic
Permit No.
Fuel
Space Htg
Water Htg
unit will have 3 ki[owaft or
more installed electdc space heating equip.
Infiltration control option is: []
of joints. [] Blower door test. []
air infiltration barrier.
Envelope 28969 BTU/HR
[]~j~ 2-Story
Other [] Seasonal Infiltration 15682 BTU/HR
Permanent [] Municipal Utility
Plus Basement Other $182,610.00
The applicant agrees to comply with ail applicable codes, statues and ordinances and with the conditions of this permit, understands that the issuance of
the permit creates no legal liability, express or impJ~ed, on the Department or municipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE Y'~ /~;~/,~ ~ ~/,~ DATE SIGNED .~
This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
~,PPROVAL CONDITIONS revocation of this permit or other penalty
see standard conditions of approval
[] Town [] Village [] City [] County L_J state of: Municipality Number of Dwelling Location:
CityOf Oshkosh 7 0 2 6 6
Plan Review $75.00 Construction
HVAC Name Nicole Krahn
Inspection Electrical
Wis. Permit Seal $30.00 Plumbing Date 06/03/2003
Other Erosion
Total $105.00 292202 Cert. No. 248101
SBD-5823 (R. 07/92)
OSHKOSH
ON THE WATER
GRADE STAKE FORM
Name NICK & ELIZABETH YOBLONSKI Address
Lot Block
Subdivision Zone
Street Number Lot Dimensions
Building Grade Elevation Stakes Set At Site 06/03/2003 Set By
4405 ISLAND VIEW DR
Grade Stake Number 6959
Create Date 06/03/2003
L I Sidewalk Existing
Ward
Department of Public Works
I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation
has commenced.