HomeMy WebLinkAbout0028926-Building (driveway) � CITY OF OSHKOSH N°_ 28926
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT :
ADDRESS -� 7 7 �'� • l � � (l z`t • PLAN NO.
OWNER F� ' ' ,--,�- h�"
DESIGNER
/
USE/NATURE OF WORK �-� ��� , Z�- ^ S .—
BUILDING CONTRACTOR �l�'72��t
Size S�,�1—'' Sq. Ft. # Rooms # Stories Height
Foundation l �,d-�'L- 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
f
FEES: Valuation $ ��'� •O c� Permit Fee Paid $ ��'� J Park Dedication $
ISSUED BY t- Date� � �/y �-' Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
, � ____�� �-
SIGNATURE� "����6� �� �" � �Z�
AGENT/OWNER DATE
ADDRESS
� TELEPHONE#