HomeMy WebLinkAbout0029276-Building (roof, siding & windows) CITY OF OSHKOSH N°_ 29276
PERMIT - APPLICATION AND RECORD
TYPE: BLDG Xr HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / 03Z /q'
PLAN NO.
OWNER C aZ (J t/C
DESIGNER Q /
USE /NATURE OF WORK it �.i� 4`i� . / ■14.:
114/ Y / I ; .5,-- 42-GrAa ,/ r0
■L_'. - ` _4ir� x _ _ �t _ .f �Z.
ahe - �y71 7 ---.
BUILDING CONTRACTOR (/LET
Size Sq. / Ft. # Rooms J # S ories / Height
Foundation /5-1.0a/ 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: Valuation $ 3 <9 0 0 " Orc Permit Fee Paid $ A " 2
�, //f Park Dedication $
ISSUED B ��' .4 Date (l/ // Final /O. P
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE % L a-
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(j `/6 ` 42_
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
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