HomeMy WebLinkAbout0046503-Building (roof) N2 6 5
CITY OF OSHKOSH 4
PERMIT APPLICATION AND RECORD
TYPE: BLDG rJ HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
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ADDRESS fa...x:2_ PLAN NO.
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OWNE R
DESIGNER
USE/NATURE OF WORK iL-- s
.,.....oe'el"
BUILDING CONTRACTOR (1.;.
Size Sq. Ft. Room Stories Height
Foundation Class of Const. Occupancy Permit
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
B I FEES: Valuation c d Permit Fee Paid oa Park Dedication
ISSUED BY Date g 3 ',._S---- Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 42LLbi 3 S�
/��J AGENT /OWNER DATE
ADDRESS 3 5( fl 0,-,.. c g C
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