HomeMy WebLinkAbout0000401-Building (bath remodel)
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
00401
~P_E: _ _ ~LDG' _ ~T~ _ ~ _ ~LE~ _ 0 _ ~LBG _ 0 _ ~'GN _0 _ ~ON~NG It?:-~ FL~D_ PLAIN _C:U_~ HEI~~TA-J~
ADDRESS {i 4- 'l A~ :;!o,AJ4 Sr: PLAN NO
OWNER <DNAL{J ",J. ~7EI2.~ :!j/d- Z~Eb-/$~4-
DESIGNER
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USE/NATURE OF WORK~/~LE f't1..-'-1It:.."Y ~/ ~eNpJJ6L MThL~~
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BUILDING CONTRACTOR /l/J{)/U3~ .&vd.c;, /E.rUC
Size I 0 'f.-. (4- Sq. Ft. 1'1- ,--) # Rooms I # Stories Height
Foundation ' Cla~s of Const. {Lbd 0 rd.:c--Qccupancy Permit ~r ~:iJ
HEATING CONTRACTOR
~4/C?
r
Heat D NC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR M,,-t:/y-
Electric Servo New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR ~LG Y'
t .
_BT _WH _Disp
_Sink
Other
_FOr
_ L Tub
_OW
_SP
_ WSoft
_OF
_ CBasin
_Lav
_Sh
_ San. Sewer
_WC
_Ur
_ Storm Sewer
_ Eject
_SS
_ Water
FEES: Valuation $ ~C70 Permit Fee Paid $
ISSUED B&'~~ Date
/
$~-Y/
/'-/b ~
Park Dedication $
Final/O.P.
y~--
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ,c kJ cr>i.oU f ~L..~
( . AGENT/OWNER
7,- 8-~0
DATE
ADDRESS
TELEPHONE #