HomeMy WebLinkAbout0016534-Building 4) CITY OF OSHKOSH N° 16534
PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING /-- FLOOD PLAIN HEIGHT•
ADDRESS ;-,0 .12 (,'-- / A /i. PLAN NO.
OWNER "Ci l-.._ P /• / dl z
DESIGNER
USE /NATURE OF WORK ‘ ,i1 ∎ 7f : &J 11, A - -A ■ „ ' `
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BUILDING CONTRACTOR 17 r_ t - a(4)/
Size S . Ft. 4 Rooms # Stories Height
Foundation ... r‘ S Class of Const. Occupancy Permit_ C7Y
HEATING CONTRACTOR L(,)e 47
Heat ❑ A/C ❑ Vent ❑ Fuel /Syste Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR glic
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 MAW x�'I Pe f ee Paid $ e) Park Dedication $
ISSUED BY I.4J „�� Date c-O .:• ' Final /O.P.
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In the performance of this work I agre- o perform all work pursuant to rules governing the described construction.
SIGNATURE _
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AGENT /OWNER DATE
ADDRESS C
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TELEPHONE #
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