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HomeMy WebLinkAbout0040127-Building (exterior repair) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD iL/z N!! 40127 ~P_E~ _ _ ~L~~ M _ ~T~ _ ~ _ ~~E~ _ C? _ ~~B~ _ C? _ ~I~~ _~ _ ~O~~N~_ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ OWNER lab ro c J.1 II RJ) WEsr .A. Cus.rd WIlRR I cK PLAN NO. ADDRESS :J/2 · DESIGNER USE/NATURE OF WORK ~F1l2 1?Ep4/1? ~~t9J h4se;/I.; CDMP~ 5:/oI1U6 ~ ftEp^l11? DoF of 3/~1 qq.. / . ~DFA rs / A IJ?> ;JGR oR-De71.:5 p BUILDING CONTRACTOR OWIJG'R.. Class of Const. # Stories 5? Height Occupancy Permit Size Sq. Ft. # Rooms AIO Foundation HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Serv. New 0 Change 0 Temp 0 Type _ Volts _ Amps_ Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR _BT _WH _Disp _ WSoft _ CBasin _Lav _Sh _OW _OF _ San. Sewer _WC _FOr _SP _Ur _ Storm Sewer _Sink _ L Tub _ Eject _SS. _ Water Other o.Q FEES: Valua!;o~; 1=. Perml! Fee Pa;d $ ISSUED BY. ~ ... 9f..~ Date J /0. o...a. / 6/-;)4/ q'-l Park Dedication $ ~ - Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SI~NATUR 71? ~~j) !JZ1M~ 01 \ c:,~cicf-q1- t~ \ { AGENT/OWNER tI ( DATE / A~DRESS /0< y.W Cu 5 7 ?~ ~ :J ! --05'- 0 \ 2' TELE/r;~NE # '&