HomeMy WebLinkAbout0006246-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
x. W r- e e-k. c H..-5.
BLDG 0 HTG 0 ELEC 0 PLBG 0 SIGN 0 ZONING
FLOOD PLAIN~EIGHT ~ #-
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06246
TYPE:
ADDRESS
OWNER
DESIGNER
Ih
USE/NATURE OF WORK
BUILDING CONTRACTOR
T;-(GEJ
~K< A-1~~
# Rooms # Stories ,( ,~ Height 2:-0
Class of Const. 0-- Occupancy permit~
Size
Sq. Ft.
15'r~) ~k-
Foundation
'--
~
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR ~
~
Type _ Volts _ Amps_
Electric Servo New 0 Change 0 Temp 0
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
ISSUED BY
Fee Paid $ /0. tSfi;>
Date /1-/3..-g.7
Park Dedication $
Final/O.P.
,
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In the performance of this work I agree perform all work pursuant to rules governing the described construction.
SIGNATURE ~L tfid/JL
ADDRESS !T<loo Nt ~~ ~
//-/)/-0>1
DATE
~/
YII{ ';396'6;;'1
TELEPHONE # /
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RECORD OF SEWER AND WATER DISCONNECTIONS
j;
Sewer Sealed at Property Line
Date 1116;[.1
.t/67 /11~~
~s jt{~ Lt_
-~~"-
19_by
Address of Building
Name of Owner
Address of Owner
Water Disconnected at Property Line
19 _by
No sewer and water services to premises.
o
I, the undersigned, owner or agent of the above described property,
agree that all sewer and water services Wi~e disconnected and
sealed by a master plumber on or berore< ~~~
~ .., ent
Approved for issuance of wrecking or moving permit.
Date
Plumbing Inspector