HomeMy WebLinkAbout016239 - Building (replace windows) 4ip) CITY OF OSHKOSH N2 16239
PERMIT - APPLICATION AND RECORD
TYPE: BLDTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 0 / ` ,,,_.• t PLAN NO.
OWNER ` 4 ( dY4',0,
DESIGNER �` `
USE/NATURE OF WORK c 0 re I" 4� << " P 7;__ c Ai ry
BUILDING CONTRACTOR -PS o_P(
Size Sq. Ft. # Rooms # Stories ( Height
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Foundation _ 1 , Class of Const. Occupancy Permit
HEATING CONTRACTOR t-" ------ ___
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
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
acs �� /
FEES: Valuation , 4 -6� Pi it Fe 'aid $ -� Park Dedication $ '
ISSUED BY �Ir O.- ...s. f� Date //.- 7- -_CY Final/O.P.
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In the performance of this work I agree to •- orm all work pursuant to rules governing the described construction.
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SIGNATURE L / / f J�
r � AGENT/OWNER /ATE
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ADDRESS 'i G
/'Z rte: ,_,,, c , ,--75'/- G„),<
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