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Home My WebLink About0041522-Building (work above foundation) ��p � K H N°- - 4i522 � _ C TY OF OSH OS PERIIAIT APPLICATION AND RECORD TYPE: BLDG�' HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING -� FLOOD PLAIN � HEIGHT_�� ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �� /"` ��-�� S� PLAN NO��- ( � ��p � OWNER � ' �� DESIGNER USE/NATURE OF WORK � �� L' � �'`� � � �� .�b�� P cr--�,`�- /`Z�ltti � '—e � �*-t�c..�r` BUILDING CON7RACTOR d``� Size ��X��g� S . Ft ` ��'OU # Rooms �� a' '` # Stories / Height �� r Foundatio � � 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 7c Z�o /��e'�p e I!e�-s�'�� , �-,,o � FEES: Valuation $ mit Fee Paid $ ` Park Dedication $ ISSUED BY Date � � r5� FinaVO.P. In the performance this work I agree to pertorm all work pursuant to rules governing the described construction. SIGNATURE ��-- �� 'a � 3 - � `l AGENT/OWNER DATE � � � _�O ��J ��1/� Gc�.,t.t.cr" ��./'—O"" '�' � . ADDRESS TELEPHONE�k