HomeMy WebLinkAbout0024106-Building (roof)_CITY OF OSHKOSH N°_ 24106
PERMIT APPLICATION AND RECORD
TYPE: BLDG j~ HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS _ ~ ~'y(/"`. PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. ~ Occupancy Permit Q
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles
Volts Amps
Circuits
PLUMBING CONTRACTOR
-BT - WH
- Lav - Sh
WC - FDr
.-Sink - LTub
Other
Disp
DW
- SP
-Eject
- WSoft
- DF
- Ur
SS
- CBasin
-San. Sewer_
-Storm Sewer
-Water
FEES: Valuation ~~~~• 8 y 1 Permit Fee Paid $ ~' ~ a Park Dedication $
ISSUED BY Date ~ ~1 Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
ADDRESS
AGENT/OWNER
~-
DAT
TELEPHONE #