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CITY OF OSHKOSH N° � 68�$ � PERMIT - APPLICATION AND RECORD TYPE: BLDG�'"HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING �� FLOOD PLAW �%"`�— HEIGH�� - - - - - - - - - - - - - - - - - - - - - - - -///- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS ( � � � .� � ��1�� PLAN NO. OWNER ��' -� ri Jt=-v �-G,�� -� — DESIGNER L USE/NATURE OF WORK � � � � ��°"`T�'�'� �r �C°��" �' �N-� r.-:��aF �s. � / � � �� J h, 'S`c ^�3�� /�-s' (i, �i._�Ur o�� � � i [���, � �c� c `�� � BUILDING CONi'RACTOR r'�t�t' ��l " ���. 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 PLUMBWG 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: Valuation � %'Per N Fee Paid $ �f�, � Park Dedication $ ISSUED BY �������� - �� � � Date � �- - fJ Final/O.P. � ) In the performance of this work I agree to pertorm all work pursuant to rules governing the described construction. i / / ^ ' �Y� . l �'�/ SIGNATURE �'�� �'� l ��i /� ENT;OWNER OATE / S"a�' // � � ° 33 -/� v d ADDRESS o � "-����^"� '' �"' TELEPHONE#