HomeMy WebLinkAbout0004551-Building (replace header) CITY OF OSHKOSH N°_ 04551
PERMIT — APPLICATION AND RECORD
TYPE: BLDGiTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN £ HEIGH rs,_
ADDRESS E0S Z. / /1 P. Viic__ PLAN NO.
OWNER #e Iift v -- Pre _TE) f`
DESIGNER A USE /NATURE OF WORK ` 1 • (r PF td i; e e op-- r ` o V c /
h P cx A I ) rl P pi. 0 4 5 re, /5(77 rc 4
BUILDING CONTRACTOR `Tr pr.... R d kt°
Size /0 N . ( tS^ q. Ft. 3 ®C`7 # Rooms # Stories Height �-5
Foundation P.—. � 71`P Class of Const. g Occupancy WS.___
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
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FEES: Valuation j.„ /���w Pe,,,l- -e Paid $ v Q p Park Dedication $ `�
ISSUED BY t %1 Av_► ..., % / Date 7 ` / -. U 7 Final /O.P. 7"
In the performance of this work I agree / 7. orm all work pursuant to rules governing the described construction.
SIGNATURE -���'\
AGENT /OWNER DATE
ADDRESS �J zj3-' 15
TELEPHONE #
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