HomeMy WebLinkAbout0027373-Buildng_CITY OF OSHKOSH N°_ 27373
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING - FLOOD PLAIN HEIGHT
ADDRESS ~ 3 ~ ~ ~~ %~~n ~j'2~ GL.~~ • PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK~~~J~~~ Gt. ~~~~ ~ a
~~
BUILDING CONTRACTOR ~~C~
r
Size Sq. Ft. # Rooms # Stories Height
Foundation C/4!'n- Class of Const. ~ Occupancy Permi
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles
Heat Loss BTU'S
Volts Amps
Circuits
PLUMBING CONTRACTOR
BT _ WH Disp WSoft
- Lav _ Sh DW DF
WC FDr SP _ Ur
-Sink LTub Eject SS
Other
FEES: Valuation $ a ~~- ~ ~ Permit Fee Paid $ ~0° 0O Park Dedication $,t,
ISSUED BY Date dZ Final/O.P. ~~~// ~~'
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATU
11~ ~Cn~etS~
AGENT/OWNER
ADDRESS
CBasin
-San. Sewer_
-Storm Sewer
Water
a-~~-gz
DATE
TELEPHONE #
OWNER
DATE RMIT #
GE ~T RAL NTRACTOR
MASON.CONTRACTOR
Width of lot
ZONE
0
w
0
y
d
m
A
Front of lot
ADDRESS 33~ ~ Cam,
USE ~~
Wo~ck coos is is of
DATE INSPECTIONS
REIyiARKS
L ~ ~~
MAILING ADDRESS