HomeMy WebLinkAbout0010473-Building (misc. extrior & interior) CITY OF OSHKOSH N ° 10473
PERMIT - APPLICATION AND RECORD
TYPE: BLDGHTG ❑ ELEC p PLBG ❑ SIGN ❑ ZONING FLOOD PLAIHEIGHT
ADDRESS 1 Z ( Ai; ((
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OWNER I'Cc (!t C-1' c.) ! r C.") &kJ
DESIGNER ,�
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SE /NATURE OF WORK c' _ - ata w. e L. p , ',
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BUILDING CONTRACTOR 4,i' - c 4.., ...M (.(3 , P/"
Size Sq. Ft. # Rooms
# Stories P Height
Foundation � c` I- Class of Const. o Occupancy Permit /-eO
HEATING CONTRACTOR -- '..
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss
BTU'S
ELECTRIC CONTRACTOR OA, ..,..`,►-
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 4 i o•
- 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 $ ��� °� .—�
i•• it / /aid aid $ '(� �,�� Final /O.P.
Park Dedication $
ISSUED BY Al / _ , . I �� __ ,! �.. Date f' - /L ' O
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In the performance of this work I agree to p=rf.rm all work pursuant to rules governing the described construction.
SIGNATURE t
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_C .111- - / Ii 9,7:.
AGENT/OWNER /� DATE
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ADDRESS / 7 •L Sfi/11 +-►; v i <4
, -1 L6-I C6 ( A9-6— 3
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