HomeMy WebLinkAbout0021575-Building N -a
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CITY OF OSHKOSH N2 21575
PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING / FLOOD PLAIN HEIGHT
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ADDRESS - f-' `� ° S� PLAN NO. 67 W f !SI (7/J
OWNER Or Pt- e —cc Cp cr—
DESIGNER j ' ! `
USE /NATURE OF WOR .,�.: • O"' _ " - - ) ( e 2 _ t 1 4c. - • -lcYr (ro
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BUILDING CONTRACTOR � _ V P 7etr"
Size/O -S Z / ! Sq. Ft. # Rooms # Stories / Height
Foundation �jC e�f Class of Const. 67' Occupancy Permit A.10
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HEATING CONTRACTOR 4 ft r
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Heat ❑ A/C ❑ t Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR � `V C ` r °L
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Electric Serv. N ew ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures = P r i Switches Receptacles Circuits
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PLUMBING CONTRACTOR ecc2Y r
BT 'i ' WH Disp WSoft CBasin
_Lay t Sh DW DF San. Sewer
WC y FDr SP Ur Storm Sewer
Sink 9 LTub Eject SS Water
Other
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FEES: Valuatio .mot= 4 P r i it' Fee Paid $ = Park Dedication $ r
ISSUED BY Il . 1_ < !1e.
Date ��' "D Final /O.P.
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In the performance of this work I agree • perform all work pursuant to rules governing the described construction.
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SIGNATURE { l [ S 7c'� ' CD
AGENT /OWNER ATE
ADDRESS l e:F S k0 . 7 0 a1/4-§-4(4-3,s,4 t ( y (`t) `I Z6 - I z.
i TELEPHONE #
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