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HomeMy WebLinkAbout0026997-Remodel ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 26997 ~P_E~ _ _ ~L~~ _~ _ ~T~ _ ~ ~~E~ _ C? _ ~~B~ _ C? _ ~I~~ _~ _ ~O_N~N~_ _ _ _ _ _ _F~~~D_ ~L~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ OWNER /61. ~ tilth 11-(/& j)4V? >dor-r , PLAN NO. ADDRESS DESIGNER USE/NATURE OF WORK tI~rt.n-y.. . 03(/J' /J/it.j it -e~~tfYL7 BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Class of Const Height Occupancy Permit Foundation HEATING CONTRACTOR Tt!1/t 'ih 5i('e-~ 1- ~~. Y-l~ YJ Heat ~ AlC ~ Vent '@ Fuel/System 1J.:-6i.. Heat Loss. JJs Jtp p /1!7f;otJr? J ~ IflQ'1t?n IJI L. .I l# ~.hn /IIe./ q Bl~c: t'ItH? ELECTRIC CONTRACTOR BTU'S.J.e //177 ~ .. ,. ~ Id e1 ~ ~n &e- - ~ Electric Servo New 0 Change 0 Temp 0 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 $ ,.. 91'0: &It:' ISSUED BY ~ I -2q,~)~1 Permit Fee Paid $ 'v _.~ ~ Date Ij J2q/~.fJ- Park Dedication $ Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE / l~c:l/1 ~ ADDR <V' TELEPHONE #