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Home My WebLink About0012984-Building (repair block foundation) � _ CITY OF OSH KOSH No � 2984 PERMIT APPLICATION AND RECORD TYPE: BLDG��HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS v ` � L—C�-�• C � /p'��,�.° PLAN NO. OWNER � C ("f/L-Q 0"�'X ti c^a� � (�� tn h'u�t T DESIGNER USE/NATURE OF WORK �° � ` � . � � � � ' �� e ` r� S't9it-ti r'` �`�- Rllll I�ING C'nN7RA('TnR �� P!`a�oC'� Size Sq. Ft. # Rooms # Stories � Height Foundation �. ��p� Sr °'��e Class of Const.�— Occupancy Permit� ��oc.l� c 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: Valuation P Fee Paid $ l� �— Park Dedication $ "�- ISSUED BY Date �� 'g9 Final/O.P. In the performance of this work I agr o perform all work pursuant to rules governing the described construction. SIGNATURE �/� �� T/OWNER DATE � ADDRESS � ,� �'� � y�� TELEPHONE# .