HomeMy WebLinkAbout0151221- Building (fence) •
P O Box 1130
City of Oshkosh
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application www.ci.oshkosh.wi.us
Project
Address D O.S /"
Applicant \.OwneD Contractor Tenant Other(describe)
Ovk ner/ Namur'c%1 AA-4 f ,3 L�-' Phone 9.1-0--61
Tenant
Address l0 o.S' Email
Contractor Company Name GJ//LC Phone
Contact O/LfI' i Email
Address 3-7.-12-1° e.). •'c"10-0"0"`-'4) S . dAlp(...cf7"2" 4-c1/
State Credential#'s
Dwelling Contractor Qualifier# Ehcelling Contractor# Building Contractor Registration#
Achitect/ Company Name S ✓ f Phone
Designer
Contact Email
Address
Permit Type Residential Single ami Residential Duplex Commercial Multifamily Industrial
Catagory Ileal Addition Alteration
Project • .4X 6r w.., Gr/C/ 5s% eCtrr,c- v' /�.✓� �/pch4ccr N//S'c.J
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job �+ `^�
$ Ta!i (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check #Waal 1330/ Cash Permit Fee Account
I certifil the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
btained. I acknowledge nd agree to these terms.
Name: (Please print) Date: 7-76-/-g
Signature: � �-
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120 .0 M OfHKOIH
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DISCLAIMER
CS This map is neither a legally recorded map nor
•survey and it is not intended to be used as one.
This drawing is a compilation of records,data
and information located in various city,county
CS and state offices and other sources r referee
the area shown and it is to be used for refereate
O O purposes only.The City of Oshkosh is not re-
sponsible for any inaccuracies herein contained.
1(discrepencies are found,please contact the
`D O City of Oshkosh.
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Source:City of Oshkosh GIS