HomeMy WebLinkAbout0042958-Building (misc. interior & exterior) r�-
CITY OF OSHKOSH N 42958
PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 6a / ' 4 /tip brig PLAN NO.
OWNER N 1 IZO' Z
DESIGNER
USE/NATURE OF WORK Cs Y h �—p
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N€U , . w 7 �w,�
stoe OJ % 3 ?s wt 1c) Cis& iRra• CE < 3 slckui
2r Ep e me , 1/45K - (.t-ac sTZvc 1.P. waJZ1C)
BUILDING CONTRACTOR CC)3
Size Sq. Ft. # Rooms # 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
FEES: Valuati d yco ` Permit Fee Paid $ ` t, Park Dedication $
ISSUED BY Date L � l � k Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE �"'z �� / � 4.519Y
9Y
- NT /O/ R / DATE
ADDRESS 9yL /-
TELEPHONE #