HomeMy WebLinkAbout0030500-Building (entrance)
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CITY OF OSHKOSH N~ 30500
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ~TG D ELEC D PLBG D SIGN D ZONING FLOOD PLAIN HEIGHT
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DESIGNER ~
USEINATUR,E OF WORK ~!e~ 'R:t~~ r'e~r- 'f? I'L~"-t!.e.
MF!.f?Y- ~ -~ r V_, __~F&A....i-.J
OWNER
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BUILDING CONTRACTOR
8fl ~;c. e r--
Size
Sq. Ft.
# Rooms
# Stories
Class of Const. ~
Height
Occupancy Permit
Foundation
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HEATING CONTRACTOR
"--
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Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
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ELECTRIC CONTRACTOR
Electric Servo
New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR ,.-
-.
_Sink
Other
_FDr
_LTub
_Disp
_DW
_SP
_ WSoft
_DF
_ CBasin
_ San. Sewer
_BT
_WH
_Sh
_Lav
_WC
_Ur
_ Storm Sewer
_ Eject
_SS
_ Water
ISSUED B
Date
/'0 :--
~.:?;/~~
l
Park Dedication $
Final/O.P.
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In the performance this work I agree to erform all work pursuant to rules governing the described construction.
SIGNATURE b~$. ~
AGENT/OWNER
0/1/ jCi;L
DATE
;:>_~~~ 319e;;
TELEPHONE #
ADDRESS