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Home My WebLink About17971 BLDG (Raze) CITY OF OSHKOSH N°_ 17971 � PERMIT - APPLICATION AND RECORD (`�I,P��cr,�� .� �� TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN� HEIGHT��` ` - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � � C O � ��'G'z._• PLAN NO. � OWNER �-v��- 6 E--�lt,� S O � � ; DESIGNER USE/ TURE OF WORK � �l � � ` � 2� � �� ' - � � BUILDING CONTRACTQR N �`� � � � /�� Size � � '�L 3 Sq. Ft. 2 # Rooms # Stories Height Foundation /�O �/'f 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: Valu on '$ � � Permit Fee Paid $ �� Park Dedication $ ISSUED BY Date r�� ' �� Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. 1-1 — >L -�a SIGNATURE ` AGENT/OWNER DATE ADDRESS � � G� S �,� � B S?�� Cj��—S_�Q Z-- TELEPHONE# .