HomeMy WebLinkAbout0155937-Building (sign) �"� Cit,of Os�osh P O Box 1130
Oshkosh,WI54903-1130
Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application �W�;.oshkos6.W;.�s
Project
Address � �� � Lv . C(� ��
Applicant Owner Contractor Tenant Other(describe)
Owner/
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Contractor Com an Name_ ,
P Y �(vc�. uir a�rc;AS Phone �zri- QZ(- `7'lg(
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State Credential#'s '
Dwelling Contractor Qualifier# � Dweqing Contractor# � Building Contractor RegisUation#
Achitect/ Company Name
Designer Phone
Contact Email
Address
Permit Type Residential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
PrOject �..��� �P Gi-�izen S � �
Description - c�� r n n t �- ���O��r�� �-,5�,
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Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbin b —
g Y Heating by
Value of Job $ ���� ��
(Value for materials 8c labor is req.to ensurc consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
/cert��he above injormation rs comp/e1e and accurote. Any deviations from the above submitted informalion may require additiona!permi�s
to be obtained. lacknowledge axd agree to rhese terms.
Name: /� ��-�.L , (Please print) Date: 3-�-(3
Signature:(�'t-�