HomeMy WebLinkAbout0010074-Building (soffit & fascia) CITY OF OSHKOSH N° 10074
PERMIT - APPLICATION AND RECORD
TYPE: BLDGTHTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAT.±_ HEIGHT
ADDRESS / bR AO (f
PLAN NO.
OWNER -.1 (k `cw_ 7..... � k 5t_.,
DESIGNER
USE /NATURE OF WORK k4 a- v4-4- c ( nio_0A- , S o 1 ' Pcc-c--14‘--- ,
BUILDING CONTRACTOR K C-' i e G CO t/:4'.
Size Sq. Ft. # Rooms # Stories _i Height
Foundation Class of Const. V Occupancy Permit A./
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
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 % P j as
erm j P aid $ Park Dedication $
ISSUED BY (0 ! 1 . . ! it a Date -" 2 �\ Final /O.P. • /t"
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR _ A..__ _ 0 4 . _
(1)- A ENT /OWNER �� �
DATE
ADDRESS / 7 7) / rlr, . t c L 0Fe TO r (7233 - 4 Fri
TELEPHONE #