HomeMy WebLinkAbout0047011-Building (foundation repair) 1
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CITY OF OSHKOSH N° 47011
PERMIT - APPLICATION AND RECORD
TYPE: BLDG X HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /5 f O f / CI. fl PLAN NO.
OWNER Javv€S
DESIGNER a
USE /NATU - - • F WORK 5 • �_I a AI! e - A T
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BUILDING CONTRACTOR MIMES P C=
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. 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
BT _ WH _ Disp _ WSoft _ CBasin
- Lav _ Sh _ DW _ DF _ San. Sewer
— WC _ FDr ._ SP _ Ur _ Storm Sewer
— Sink _ LTub _ Eject _ SS ._ Water
Other
FEES: Valuatio s• + : i i t Fee Paid $ Z J =_
�� . ..--- Park Dedication $
ISSUED BY ■ .. ����=7 ■ Date 9' / Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE t Yom/ ,� ?"-Yr
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AGENUOWNER DATE
ADDRESS //! 7 Q ,Q dh � I!/ , TELEPHONE