HomeMy WebLinkAbout0041093-Building (siding & roof) /91
CITY OF OSHKOSH NA 41093
PERMIT - APPLICATION AND RECORD
TYPE: BLDG Al HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS
)/J' MoAiikb6 ..5 PLAN NO.
OWNER NO U a r 6 A / o f
DESIGNER ' U SE /NATURE OF WORK
(S A I C lAa. V 1 Nq�- �/'O l�6 Q Hoo6
NJ E - Roof- - �4 R OFD (Xi) La /A1.6
OA -6VA
BUILDING CONTRACTOR ri_JE
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. 0 Occupancy Permit /0
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Senn. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
____BT — WH _ Disp — WSoft CBasin
_Lax/ _Sh _ DW _ DF — San. Sewer
_WC — FDr SP — Ur __Storm Sewer
Sink — LTub _ Eject __SS — Water
Other
FEES: Valua 3 , Permit Fee Paid $ Park Dedication $
ISSUED BY Date Vm/Qc/ Final /O.P. �—
�,�1 ate
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE - `'3 '' d f �
AGENT /OWNER D ATE
ADDRESS CMG /)9i4L 106 C L"+ ■ i. 4 41 0 4.4-4 53' 'j .3/— ,l 7,<
TELEPHONE #