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HomeMy WebLinkAbout0017919-Building (siding) � CITY OF OSHKOSH N° 17919 . `' PERMIT - APPLICATION AND RECORD TYPE: BLDG � HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ° ADDRESS ���r � �� !��/`t' PLAN NO. c OWNER f�0� �c° �G'J< (" S DESIGNER �<< � USE/NATURE OF WORK � �- w /'�'��� � « w� P t / BUILDING CON7RACTOR �,�"e�-�X �E'S�'r�CJ[-t.,.� Size Sq. Ft. # Rooms # Stories � Height Foundation Class of Const. � Occupancy Permit �a 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 `�—v BT WH —Disp —WSoft —CBasin Lav —Sh —DW DF —San. Sewer WC —FDr —SP Ur —Storm Sewer —Sink —LTub Eject —SS Water Other / FEES: Valuation � � Per 't Fee Paid $ 3�✓ Park Dedication $ �— ISSUED BY Date 7"`,�/ ' �'� Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. R l / SIGNATURE �G� C —/� �v � AGENT/OW R / DATE ,. ADDRESS�//�/ "�� � ,�v � � �,1 � i `Z/� S�/D I �(�S�� TELEPHONE#