HomeMy WebLinkAbout0021329-Building
~
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
~ (cA~~
BLDG D HTG 0 ELEC 0 PLBG D SIGN D ZONING FLOOD PLAIN
N2 21329
TYPE:
HEIGHT
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
OWNER
/11 { (T"~~~1t>1 ef
~D'ff- Atv--e~ ~4-~~h
PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK )cc.. c (':'>
r
...
,
~ 'f'~ v.<:-
~s<r
Size ~. Ft.
Foundation .. f- r' ~ r--
# Rooms
tories
/
Height
BUILDING CONTRACTOR
Class of Const.
.~
Occupancy Permit
/Vo
HEATING CONTRACTOR
Heat D AlC 0 Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR c
Electric Servo
New 0 Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
Kof' ;;
_Sink
Other
_FOr
_ L Tub
_Disp
_OW
_SP
_ WSoft
_OF
_ CBasin
_Lav
_WH
_Sh
_San. Sewer
_BT
_ Eject
_SS
_ Storm Sewer
_ Water
_WC
_Ur
ISSUED BY
~-''''''--'
'-,
ee Paid $
Date
Park Dedication $
-_..
Final/O.P.
In the performance of this work I agree to erform all work pursuant to rules governing the described construction.
SIGNATURE
-B~~<r fl c1MP~
AGENT/OWNER
I I / Z / 9cJ
,
DATE
ADDRESS
uJ .gOsl
\...t V ~3
BE /l-t/E/? O;:J/l}
~g7- ?030
TELEPHONE #