HomeMy WebLinkAbout0030021-Building 40) CITY OF OSHKOSH N°_ 30021
PERMIT - APPLICATION AND RECORD
TYPE: BLDG y HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 2 - 7 3 S - �" PLAN NO.
OWNER 9 ) i
DESIGNER
USE /NATURE OF WORK /0 >77, , -a -,-y4 24 71-
BUILDING CONTRACTOR "It •
Size Sq. Ft. # Rooms # Stories / Height
Foundation 4,7"-V Class of Const. 6 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
00 O . !
FEES: Valuatio $ 0 O Permit Fee Paid $ „ O • e) ° ::1:1tb0n $
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE GA tf-
AGENT /OWNER DATE
ADDRESS
TELEPHONE #