HomeMy WebLinkAbout1989-Building (raze) CITY OF OSHKOSH No 1
PERMIT — APPLICATION AND RECORD
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TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING / 64L Z- FLOOD PLAIN la HEIGHT
ADDRESS t /0C 0 i pC7/J LAM R_ PLAN NO.
OWNER 4 - - Co P
DESIGNER
USE /NATURE OF WORK a\Af (A . TC P=1 'Jr �(- 4 4 { c' ( - al Zirc.- RW LOM
3UILDING CONTRACTOR /COLA Va
7 pf4�r' /
Size r,) K 7c) Sq. Ft. " - C -17/ ° 0 # Rooms # Stories / Height
Foundation C-4-3A-1 C S( 4A Class of Const. * C Occupancy Permit
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
PLUMBING CONTRACTOR i k714 f 'r
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
/) V
FEES: Valuati n v d _ CIO Permit Fee Paid $ Park Dedication $ � ' � (a-
ISSUED BY 4 A / 1 � -- 8'
Date Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE Y
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j AGENT /OWNER DATE
ADDRESS 5 .-- / G�� o/ (07)--9 ?- 0 2
TELEPHONE #
RECORD OF SEWER AND WATER DISCONNECTIONS
Date /' / 2 — CTr
Address of Building /766 2 i (
Name of Owner 2-7—X
ca r
Address of Owner
•
Sewer Sealed at Property Line 19 by
Water Disconnected at Property Line 19 by
No sewer and water services to premises.
I, the undersigned, owner or agent of the above described property,
agree that all sewer and water services will be disconnected and
sealed by a master plumber on or before
(0 er)
Approved for issuance of wrecking or movi
Pe .i
•
Date I-
Pluubing Inspector