HomeMy WebLinkAbout0026123-Building (siding)_CITY OF OSHKOSH N°_ 26123
PERMIT APPLICATION AND RECORD
TYPE: BLDG ~ HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~ 3 3 ~ C~ ~'~,~L.d~~./ PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
J _ _ '"
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BUILDING CONTRACTOR l../tYI/.~_~
Size ~ d Sq. Ft. # Rooms # Stories Height ~j
Foundation Class of Const. ~ Occupancy Permit ~ `a
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ 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: Valuatio $ a ~ O Permit Fee Paid $ ~~
" ~ ~ Park Dedication $
ISSUED BY Date /
~ ~/ ~{~! / Final/O.P.
In the performance of this work I agree to perform all ork pursuant to rules governing the described construction.
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SIGNATURE ~ /
AGENT/OWNER DA
ADDRESS
TELEPHONE #
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