HomeMy WebLinkAbout0005566-Building CITY OF OSHKOSH N2 05566
PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING ^ 1 FLOOD PLAIN HEIGHT N ( 4
ADDRESS 1 108 M ODE LA T T PLAN NO.
OWNER RI CI-1A 12_,c• . KIJEC6fr
DESIGNER
USE /NATURE OF WORK �/ °U c' E - Fa ti f (< - Per y I 7 0� /91,4 7/ -MALI / FAr r #
0 / (_ ("/C- a 41 e oM /et./ 4-S ov r'
BUILDING CONTRACTOR es�� � AA/711 A• is CreAlf<4.4 re,4_ rat-
Size 6 /fig / Sq. Ft. 4 84::3 # Rooms I # Stories Height /�
Foundation Class of Const. 8 Occupancy Permit Wm" / lid-4
HEATING CONTRACTOR 0044 t N G S
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR CIv 1 c" J'
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR )4-Vir 144x
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other ...-- /
FEES: Valuat Permit Fee Paid $ Park Dedication $ N A
ISSUED BY ' Date 9 Z. e 4 7 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE At4 2
Y 2�
AGENT /OWNER ATE
ADDRESS .7 � ��L G /.� c ,33 4. 6 $l W
TELEPHONE #