HomeMy WebLinkAbout0025398-Building (misc. repairs)
~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
25398
~P_E~ _ _ ~L~~ ~ _ ~T~ _ C? _ ~~E~ _ C? _ ~~B~ _ C? _ ~I~~ _~ _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _
7!G, Mrft/~
K~ t3&0~
ADDRESS
PLAN NO.
OWNER
DESIGNER
BUILDING CONTRACTOR &kJ7tL.A.-,
Size ~ Sq. Ft.
Foundation ~.
# Rooms
lr
# Stories
p.
"'2.--
Height
Occupancy Permit ~ \
Class of Const.
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo New D Change D Temp D
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 _ L Tub _ Eject _SS _ Water
Other
,
FEES: Valuation $ 3000, Oc) Permit Fee Paid $ ;La ,0 (.) J
ISSUEDBY ~)~~ Date r!lr/q.f
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 -? J....t~_....__......-
AGENT/OWNER
ADDRESS P. () ~ 1)0 X ~;;;. 0
l,A//I1/J.e bcrq 0 WI
./ /
c;/I$/l'/
I DATE (
5'~f ~ ~ :;;. 3/-~d6C)
TELEPHONE #