HomeMy WebLinkAbout0012591-Building (siding) A ® CITY OF OSHKOSH o
N_ 12591
PERMIT — APPLICATION AND RECORD
TYPE: BLDGHTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING/e r FLOOD PLAINAt HEIGHT 4 4
ADDRESS Q 2 / (S St PLAN NO.
OWNER VI 6 7 rvii .n SC /-/R K
DESIGNER
USE /NATURE OF WORK ---r -L- i ' /;M 1 L- y 4I /1)4.4 -/ le6910 v‘- "--1:-.5.--/ s Ti��
'Q 0 (AA- G ,&i /40 V S-E ✓ c cC C: r l /i (S jj /A 44 � C 4,V6
A C -a r-- C.. (,& O 0 c-t/ r (Ali Try A LtiA4 Iv Ci*i� Ou- �-- oV /-/AA C u /
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BUILDING CONTRACTOR <_L' 74Q!Y1.4- /4 a:
Size Sq. Ft. lS # Rooms # Stories Height //����
Foundation Class of Const. e Occupancy Permit/w7 ,�a<QCi12.
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 / --7 ' + Permit Fee Paid $ 4
` Park Dedication $ N /,4
l
ISSUED BY .' ..A A w it.... Date 3.- 675 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR — )2 --r
I AGENT /OWNER DATE
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ADDRESS A' 6 / I � � .. l r j 5 - O) d (p
TELEPHONE #