HomeMy WebLinkAbout0023301-Building n CITY OF OSHKOSH N� 23301
`' PERMlT - APPLICATION AND RECORD
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TYPE: BLDG� HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING '� FLOOD PLAIN HEIGHT
ADDRESS �� � ������1i( �.t�C PLAN NO.
OWNER �✓ /�-�iG�'[/
DESIGNER
USE/NATURE OF WORK � Ls�L1� lJ.,�..�'�1'��.�i.0 <C+��fl�l.�
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�' �r�/Q� . l' 2� � � .��/�-� a�-f�--
BUILDING CONTRACTOR /yGU'�U/�
Size Sq. Ft. # Rooms # Stories � Height
Foundation �1.�/1' Class of Const.� 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
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FEES: Valuation � ` �0 Permit Fee Paid $ ��'Q� Park Dedication $
ISSUED BY , Date � Final/O.P. /a "'S"`�)
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE��-��3���, u �� ' ��
AGENT/OWNER DATE
ADDRESS
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