HomeMy WebLinkAbout0041737-Building (basement block walls) /4/
CITY OF OSHKOSH N9 41737
PERMIT - APPLICATION AND RECORD
TYPE: BLDGHTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /6/■_3 )e-..r4 P' !'t PLAN NO.
OWNER 3::: N i FA / K Ck
DESIGNER
USE /NATURE OF WORK S iq . tp tv f p— cZ S re wr r. Ain ls&
BUILDING CONTRACTOR "Re e/"S'!9K )P 9 A P/'-' tint e`
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit ..oe''o
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR `---------
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
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PLUMBING CONTRACTOR
- BT _ WH _ Disp _ WSoft _ CBasin
- Lav _ Sh _ DW _ DF _ San. Sewer
- WC _ FDr __SP _ Ur _Storm Sewer
— Sink _ LTub — Eject _ SS —. Water
Other
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FEES: Valuation $ �.!�1 Permit :. Paid $ 4111P Park Dedication $
ISSUED BY � /- . _ _ . ,. ,. _. �i
Date Final /O.P. I L
In the performance of this w. rk I agree to perform all work pursuant to rules governing the described construction.
SIGNATU - /AI
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AGENT /OWNER
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ADDRESS e22 Z tf-9 re �4- u (:fi¢, , 33 - 5 1 z-1%
C/ _ TELEPHONE #
OWNER `S in I e . ) I n C h ADDRESS I01 4 C'A ci
DATE gaCr a y PERMIT # L n N1 USE Si:
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t( tilR(��1( , Wqrk cons JR is of D \JLr NiU orkmtn".
GENERAL CONTRACTOR
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MASON.CONTRACTOR ZONE .
Width of lot DATE INSPECTIONS
REMARKS
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Front of lot MAILING ADDRESS