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N2 37687
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGA SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 9,)/ /U- Zet, PLAN NO.
OWNER J1 j4
DESIGNER
USE/NATURE OF WORK ? �LL �lam) �►L�/L�'
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 C a/YY1 irn,6/7_4)
BT WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject • SS Water
Other
FEES: Valuation $ 5-30• cc. Permit Fee Paid $ /0• o c Park Dedication $
ISSUED BY v Date f f/ i/97 ,) '1'94 Final/O.P.
In the performance.afjhis work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/O ER DATE
ADDRESS
TELEPHONE#