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HomeMy WebLinkAbout0003172-Building (2nd floor alterations) � CITY OF �SHKOSH PERMIT - APPLICATION AND RECORD N� - �3172 TYPE- - _BLDG�HTG � ELEC [] PLBG � SIGN ❑ ZONING �`� I , I _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ FLOODPLAIN �� HEIGHTI�L1� -7 - - - - - - - - - - - - ADDRESS Z� / � I-� V� - - - - - - - - /! PLAN NO. OWNER `��E-�c,vA�(3 � (-�CI�-�/lc,f� �-!� 3� L � M!� i,V(� . DESIGNER US / TURE OF WORK w b F-/�� �L- � �� � / CT�J' Z�,t( ��c� ` ( � (_A-e t�/�,. C'j.�J 4vD ��-�.L C�as.tl-�-�! '— ��.� �7'�c�'w�' r�v� �J �d x i�'!n,'��, � d V'�G2, F'.C.� ��'4 d,C S"��i,� c��ll��j. "�- -�L4e,� ,�k7'�42ro�.-17��,ti �o BUILDING CONTRACTOR c� ���� ,�'�i.' lo '�r � i ���-� � Size��x r r � S'�.,2 �� Sq. Ft. � � # Rooms � � Foundation �-� S ?�,v` # Stories Height C�-�-C.� Class of Const.�� _ Occupancy Permit C/.�./�,.�/� HEATING CONTRACTOR � Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Serv. New ❑ Change [] Temp � T e YP Volts Amps Fi�ures___ Switches� Receptacles�_ Circuits_� PLUMBING CONTRACTOR /yj,��s —BT _WH —Disp _WSoft —Lav —CBasin _Sh —pW —DF _WC —San. Sewer —FDr _SP —Ur _Storm Sewer —Sink _LTub _Eject —SS _Water Other FEES: Valuat' n �5� / , Permit Fee Paid $ ` � � ISSUED B ! � Park Dedication $ � � Date ��� 7�a r] Final/O.P. /`/��7 In the pertormance of this work I agree to pertorm all work pursuant to rules governing the described construction. % . SIGNATURE � GEN / NER � / ADDRESS � . � � � DATE �33 - TELEPHONE '� OWNE W (�9 i c�S ADDRESS�/"Zo 7 ��` �'1 , � � DATE =�� PERt1I # /' � USE --J v � � �----- � ���� Wo�Ck con�s ot w � r ' e GENERAL CONTRACTOR = . i � : � � MASON CONT£ACTOR ZONE � Y - DATE �ZNSPECTIONS • FOOTING FDTN SLAB � BACRFILL STRUCTURE ENERGY I� OP ������ , ����'�7 � � �'^�-� ' 4 � i�v� ] ��� S�'�O WC��� Y �eC2`s �� ,�� Gc.lm�ldC Cm �E •' ��e C t✓e Q.._ C C P S � `f-oa�/'; ��I � �t.'�v1..���r�'v f.�.S �� . I