HomeMy WebLinkAbout0030944-Building (fire damage) CITY OF OSHKOSH N°_ 30944
PERMIT - APPLICATION AND RECORD
TYPE: BLDG X HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
7 J L �.j�
ADDRESS J / '( ,-,( 4.xd (�- ` 4- PLAN NO.
OWNER ` C ' O`-
DESIGNER
USE /NATURE OF WORK 4 if f ✓zi/ i, N 1i// P1 .i% /.E1. _ ' .
ntze -e.;? P iffl
BUILDING ONTRACTOR f91€/4
Size Sq. Ft. # Rooms # Stories / Height
Foundation Class of Const. F fr-
Occupancy Permit jee.
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: Valuation $ / 0 0 • c7 Permit Fee Paid $ /0 . 0 Q Park Dedication $
ISSUED BY ??4.4"-- Date ? *Z. Final /O.P. igg/g3
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 11( .1s , 9"c;28_ 2
AGENT /OWNER DATE
ADDRESS
TELEPHONE #