HomeMy WebLinkAbout015300 - Building (repair chminey, siding) CITY OF OSHKOSH N°_ 15300
PERMIT - APPLICATION AND RECORD
TYPE: BLDG . HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /S7-3 7 Ail", V c r rt-Q j1 PLAN NO.
OWNER Z tJ _ Q-e_ I/',,,C,. , L,:,it cX/r C
DESIGNER
USE/NATURE OF WORK S,tc it G cu r 1 iZ ° i c— C�4 r'r�, t� t ` '�"y' c.(PC-- .�ca,-,', (, .iifr,,,„,_,Lar„j,et, 't,v r-(2 0c A.-: .' E. lit CL)(._ y v'" f' r 4" c..• r1 Gte-6)(t.�` G`� t,L '(-K t
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BUILDING CONTRACTOR 6-e ir5c`1C_ r` rf--- f
Size Sq. Ft. # Rooms # Stories / Height
ysio
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTORS cc *""
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR ITN1_s
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 $ .4l / P . /tee Paid $ �---. Park Dedication $ ''
ISSUED BY ! - - _ ��• Date cP/'(rF' J7 Final/O.P.
i
In the performance of this work I agree o •erform all work pursuant to rules governing the described construction.
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�. c )74-SIGNATURE eA a -‘2L,
AGENT/OWNER 7- 3 C 7(i
DATE
ADDRESS 9),?.-- /7- S,.ti- � !y � Yd `
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