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Home My WebLink About0159941-Building (stabilize foundation walls) � P O Box I 130 City of OS��.S/G Oshkosh,WI�4903-1130 � Phone:(920)236-�0�0 Fax:(920)236-�08=4 Building Permit Application ��'w•ci.oshkosh.wi.us Proj ect � ) �` '` `- Address _� ' "I 1 �,��11T ��Kl�t �� . � Applicant Owner Contracto Tenant Other(describe) O�vner! � '�\��.�t� Phone��--�1 u� Name �� Tenant Address_Qt�"l M�C C 1 T� (^��1..,+�,��-; �'�' Email Contractor " p � Company Name �V(�_ �� 1 j'�j z�-a,�t J-��.,j Phone �(o�� (r,)�� , t J Contact � P.�� 1�.� Email'�^�P�-t��)t.�..:�t�� t�,�,,.-4.< ,c:` J Address� � 't \ ,� , �'6��s,•-�- �,� , U" l.�('�,;I� ti � �� i t") State Gedential#'s ^�'�1,��t�� U�.Z�-'� , D�+�elling Contrac[or�ualifier# � D�velling Contractor# Building Contractor Registration# Achitect/ Company Name Phone Designer Contact Emai t Address Permit Type esidential Single Famil R�dential Duplex Commercial Multifamily Industrial Catagory New Alteration Project Description �_�`Ll'C h��i ��.. � � ``\�, �~�� 1C r�'cl l iYtechanicai Separate permits will be obtained for the following: Permits Electricai by Plumbing by Heating by Value ofJob '�%�(� �' j� $ �_ (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.) Payment by: Check # Cash Pecmit Fee Account 1 cerl��!he above injonnalion rs comp(e1e and acc:rrate. Any deviations from Ihe abave s:rbnritted infor»tation ma}�require additiara!permils lo be oblained. I ackxowleclge and agree 10 lhese lerms. 2 v' Name: �, �J�, � l� (Please print) Date: � � � Signature: �,�