HomeMy WebLinkAbout0030124-Building (siding) CITY OF OSHKOSH N°_ 30124
� PERMIT - APPLICATION AND RECORD
_ TYPE: BLDG� HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS I��� �7!-""�2�� PLAN NO.
��� ,
OWNER
DESIGNER
` � � v ` - 'o
USE/NATURE OF WORK/✓'�.�� /��l�i� L:v`�-4`� /.�%�=�/1� /.'Ld�r,c.l�i� �.�/�/
BUILDING C�NTRACTOR /��P/�s� �
Size Sq. Ft. # Rooms # Stories �� Height
Foundation 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
/
FEES: Valuati $ d��•v � Permit Fee Paid $ �S ��`� Park Dedication $
ISSUED BY Date��Z/1`L Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE �� 'C"� � �� l�
AGENT/OWNER DATE
ADDRESS
TELEPHONE N