HomeMy WebLinkAbout0005696-Building (siding) /� CITY OF OSHKOSH N°_ 05696
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG�HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONIN(31�� FLOOD PLAIN°�'� HEIGHT_ �
ADDRESS ��0 � ��� l� _\� PLAN NO.
OWNER ��[�l �V`U"c� V "C
DESIGNER
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USE/NATURE OF WORK �w < � � d r�
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BUILDING CQN,7RACTOR „���.� �"'�
Size�-6 X��� Sq. Ft. # Rooms # Stories Z Height �1
Foundation � ��`�� Class of Const. a Occupancy Permit�d
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S :
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ELECTRIC CONTRACTOR -- -
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
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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
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FEES: Valuation Q Per ' Paid $ G� � �U Park Dedication $
ISSUED BY Date � � ~ Z^ �7 Final/O.P.
In the pertormance this wo I agree to p rm all work pursuant to rules governing the described construction.
SIGNATURE �� '� —k /
AGENT/OWNER DATE
ADDRE r �/ ,/�
TELEPHONE# �