HomeMy WebLinkAbout0012512-Building (raze)
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TYPE: BLDG D
CITY OF OSHKOSH N2 12512
PERMIT - APPLICATION AND RECORD
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HTG D ELEC D PLBG D SIGN D ZONING ~ FLOOD PLAIN ~ HEIGHT Ai 0.
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ADDRESS
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PLAN NO.
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DESIGNER
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USE/NATURE OF WORK
BUILDING CONTRACTOR ,lg1 ;f;:VV,{1Sr
Size Sq. Ft. I () if 2..- # Rooms
Foundation &,,ue- ~ 11 LoCL<.-
# lJ-Xies
Class of Const. <3
I
Height
, Occupancy Permit
HEATING CONTRACTOR
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Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo New D Change D Temp D
Type_ Volts_ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
,/11 CyEre-
_BT _WH _Disp
_Lav _Sh _DW
_WC _FDr _SP
_Sink _ L Tub _ Eject
Other
_ WSoft
_DF
_ CBasin
_ San. Sewer
_Ur
_ Storm Sewer
_SS
_ Water
FEES: Valuati
ISSUED BY
Permit Fee Paid $
Date
/oV"/
3-'8-89
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
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TELEPHONE #
ADDRESS
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RECORD OF SEWER AND WATER DISCONNECTIONS
Date 3;;-'#
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Address of Building
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Name of Owner
Address of Owner
Sewer Sealed at Property Line 3/ {
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Water Disconnected at Property Line ,?~~
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No sewer and water services to premises. 0
I, the undersigned, owner or agent of the above described property,
agree that all selfer and water services will be disconnected and
sealed by a master plumber on or before
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( Owner ) / ~ Agent )~
or~
P1uming Inspector
A~~~ issuance of wrec~ing
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