HomeMy WebLinkAbout0021967-Building (raze) CITY OF OSHKOSH N9 21967
PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS c20 /6, »7 i'- CA- PLAN NO.
OWNER X Cie
DESIGNER
2 ,
4 1-21-1.71-6. 4.
USE /NATURE OF WORK Q _ ez.'.-€
BUILDING CONTRACTOR
Size 2.0 X ZO Sq. Ft. # Rooms # Stories 1' Height
Foundation Class of Const. Cr Occupancy Permit
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
FEES: Valuation $ /00, 00 Permit Fee Paid $ /°' 0 0 / Park Dedication $
ISSUED BY frLrt /- 1 Date ii Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .Z� '04 ` �
AGENT /OWNER DATE
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ADDRESS
TELEPHONE #