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CITY OF OSHKOSH N° »�3� n PERMIT - APPLICATION AND RECORD TVPE BLDG�HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING � FLOOD PLAI� HEIGHT/�`� " " _ " _ " _ " ' _ " _ ' _ " " " _ ' _ " ' _ _ _ " _ ' _ ' _ " " ' _ ' _ _ _ " ' _ " _ " " " _ ' _ ADDflE55 ��2"� ��� �n h `�+' �`-H PLAN NO.� T`�'�0f� OWNER ��a�° . DESIGNER USE/NATUFE OF WORK ,/�,1--�-/'�� � � f:c� �O n' BUILDING COMRACTOR �-` '�F Si� Sq. F,.J ��6# Rooms — # Stories � Height � Fountlation � ' ' ` J Class of ConsL� Occupancy Permit� HEATINGCONTRACTOR �—'�- Heat ❑ AiC ❑ Vent ❑ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR ^ � � Electric Serv. New ❑ Change ❑ Temp ❑ Type_ Vol�s— Amps— FixWres_ — Swi�ches Receptacles Circuits PLUMBING CONTRACTOR BT WH Disp WSoft Ceasin _Lav Sh DW —DF —San. Sewer WC —FDr —_SP . Ur Storm Sewer . — Sink _LTub —Ejec� SS Water Other �- • �— FEES: Valua�ion g '� P Fae Paid $ Park �edication $ ISSUED BV Date � FinaVO.P. In �he peAormance ot �his work I agree t pedorm all work pursuant m mles goveming the describetl consimction. / �- Z - �/l SIGNATURE(%�I`�� � " oa7E FGENT'OWNER nooaess—�� � C„-���-�-L �a�`wi S—_ �:3 `�-/2s9 TE�EPXONE N