HomeMy WebLinkAbout0013629
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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BLDG 0 HTG 0 ELE~ PLBG 0 SIGN 0 ZONING C-"f FLOOD PLAIN~ HEIGHT~
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13629
TYPE:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
ADDRESS (>_0 -s- jL{ cd,---kp f-
OWNER e t't.y e+ O«;{ko 'Sh
DESIGNER
USE/NATURE OF WOR~ Ì2-,,">- t"
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PLAN NO,
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73/ ~~
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¡JAJUz(JJ c-
BUILDING CONTRACTOR .:s
/0' ,lTf?""""-'7
Size t:> Xr2..v Sq, Ft {Z-<J b # Rooms
Foundation .s~&<.P [ C£>f/~C~ V--i!"--~
I
# Stories I Height 'ZO Æj;:r:
Class of ConstAr; focI rv Occupancy Permit A .1&
i.#=8 I
HEATING CONTRACTOR
-----
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
,,7
ELECTRIC CONTRACTOR
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ElectrY;(Serv,
Fixtures
New 0 Change 0 Temp 0
Type- Volts- Amps-
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
- (VI"I! &U...Lj
_BT
_WH
_Sh
_Disp
_OW
_WSoft
_OF
- CBasin
- San. Sewer
_Lav
_WC
_FOr
_LTub
_SP
_Ur
_Storm Sewer
_Water
_Sink
Other
_Eject
_SS
pO
~inal/O,P.
ISSUED B
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In the performance of this work I agree to perforr)"al.l work pursuant to rules governing the described construction,
SIGNATURE ~
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AGENT/OWNER
At£IV!
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DATE
ADDRESS
13151/
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tkl
fN L¡- 111- 5'
TELEPHONE #
RECORD OF SEWER AND WATER DISCONNECTIONS
Address
Date
of BOll".g. ~i1~ +-
Owner ~/6- .
of Owner
ó--<-ñ
Name of
Address
Sewer Sealed at Property Line
Water Disconnected at Property Line
19_by
19_by
No sewer and water services to premises. c=J
I, the undersigned, owner or agent of the above
agree that all sewer and water services wil be
sealed by a master plumber on or before
Approved for issuance of wrocking ~r movin t
6- J- -7 --- --~ '~£-ð~
Date I bing Inspec or
OWNER C,,<'-1 0 r- 0&(,./ !c::-ð.I~
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DATE (,-::<-89 PERMIT # \~(,.?<1
&-cA<I"<..W'O-r. tð.. Z(AJcÞ
GENERAL CONTRACTOR
C-4
ZONE
MASON, CONTRACTOR
Width of lot-----
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Front of lot
ADDRESS ~Oç MÞ>~rcrt-r Ò-C
USE R\JMß,(Af<..o Su Pr'4 S-?;,vU-
Wo"%:k COO.Sists of ~'õZ- B,V¡L-':>"\J(" t.
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INSPECTIONS
RE!1ARKS
MAILING ADDRESS
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