HomeMy WebLinkAbout0039271-Building (siding) r��
N° 39271
� CITY OF OSHKOSH
: PERMIT - APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS � PLAN NO.
OWNER /� �
DESIGNER
USE/NATURE OF WORK � ' ' / �
v �d
��� /
BUILDING CONTRACTOR
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
P � � �
FEES: Vafuation $ c7� C� Permit Fee Paid $ �` Park Dedication $ '—`
ISSUED BY �ate _� SI S� y Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction. .
SIGNATURE '
� --5-- 9�
AGENT/OWNER DATE
ADDRESS ��Ci � �LiL�1�� ��.1�� _� �) D I�
TELEPHONE# �