HomeMy WebLinkAbout0027393-Building CITY OF OSHKOSH N°_ 27393
PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 19 D % 4. PLAN NO.
OWNER J %f/W -a_ it' 7 Q
DESIGNER J I /�
USE /NATURE OF WORK ,/ / 't' et ..t- / re
BUILDING CONTRACTOR A -, d
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. 6' Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR ��t
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR fr -
BT WH Disp WSoft CBasin
_Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ .2-000 •O O Permit Fee Paid $ /- - 0 Y Park Dedication
ISSUED BY ?if-1 Date 2 1/41/ Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE � .C[A)(Lo 2 M 2' J4_444, 02 Zk
AGENT /OWNER U DATE
ADDRESS l Q O Y ) 44--1 - 4-1 /2/0 o Si - °Li- / - 6 . _,
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