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HomeMy WebLinkAbout0015479-Building (repair chimney) CITY OF OSHKOSH N°_ 15479 PERMIT APPLICATION AND RECORD TYPE: BLDG la HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT ADDRESS i PLAN NO. OWNER k-Na2 De W4- /lea t o e DESIGNER r USE /NATURE OF WORK a t _1r r r 'oI 6n f ,d., S 2A,0.� p r✓t �t° ro©l� r-12 t a t re, I. 4, L..i.Q 0--� l' 1 BUILDING CONTRACTOR ,b a C h t44 `f' •,10e f Size Sq. Ft. Rooms Stories Height //ff Foundation Class of Const. Occupancy Permite1 HEATING CONTRACTOR Heat A/C Vent Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR r Electric Serv. New Change Temp Type Volts Amps Fixtures Switches Receptacles Circuits c PLUMBING CONTRACTOR ,-..r ...........i..... BT WH Disp WSoft CBasin Lav Sh DW DF San. Sewer WC FDr SP Ur Storm Sewer Sink LTub Eject SS Water Other FEES: Valuation ..,IMP Permi Fee Paid AS —d- 22 Park Dedication ISSUED BY lee.. Date Final /O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE djyt c. /j ,r AGENT /OWNER DACE ADDRESS U d_ J 5// /G°�� 3 yfd 3 7---3 TELEPHONE