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HomeMy WebLinkAboutBuilding 1 �� CITY OF OSHKOSH N° 45354 � PERMIT - APPLI CATION AND RECORD TYPE: BLDG-�HTG ❑ ELEC ❑ PLBG ❑ SIGN [� ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � � � � -� �� / "1 Q�' tn PLAN NO. OWNER 4�J CZ cl CQt.l� DESIGNER USE/NATURE OF WORK �'w� � �/ c� C� BUILDING CONTRACTOR ���+ 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 �� �+� I-- 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 �' � Per ' e Paid $ � `�.. Park Dedication $ �—' ISSUED BY Date � � Final/O.P. i In the performance of t is work I agree to perform all work pursuant to rules governing the described construction. ��GNATURE� "� � ���f�*,�(� � � ^ � � ,! AGENT/OWNER pq7E � ADDRESS��� `� � ����J'V\c�-�'1 � 2�j Z: ���� TELEPHONE�Y