HomeMy WebLinkAbout0027096-Building CITY OF OSHKOSH N9 27096
PERMIT — APPLICATION AND RECORD
TYPE: BLDG W HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /5 O 9 z ,1-DY✓ PLAN NO.
OWNER 3���z� Z1-7t Q
DESIGNER / 1
USE /NATURE OF WORK J7X .2Z% e-- ■.rte 76 ) J ?'».t _.-1.-PA-
BUILDING CONTRACTOR ,-U-C "el
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Size Sq. Ft. # Rooms # Stories / Height
Foundation /3j Class of Const. 2 Occupancy Permit XI
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
7.490/ FEES: Valuation 6 D . Permit Fee Paid $ Park Dedication $
ISSUED BY —.l� .v Date / ) 2i Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / '�_ ' _id_ 1 i ■ � ':V , , / .3/
AGENT /OWNER / /
DATE
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ADDRESS
.Y .0 1.� 4-Q 3i - gti
TELEPHONE #
OWNER ADDRESS /9e7 9 G, ady-,
DATE PERMIT # USE /7/ L
_ Worrk CO nvt3tlof 4c
GENERAL CONTRACTOR
MASON CONTRACTOR • ZONE
Width of lot DATE INSPECTIONS
REMARKS
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Front of lot
:/ /61 9;11;(9
MAILING ADDRESS