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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
07870
TYPE: BLOG D HTG D ELEC ~PLBG D SIGN D ZONING - FLOOD PLAIN- HEIGHT-
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DESIGNER
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USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Canst.
HEp;TING CONTRACTOR
,.,
Heat D AlC D Vent D Fuel/System
ELECTRIC CONTRACTOR d~
Heat Loss
BTU'S
Electric Servo
New D Change D Temp r:r--
Type - Voits - Amps b CI
Fixtures
Switches
Receptacles
Circuits
jIJ,
PLUMBING CONTRACTOR
_BT
_WH
-Sh
_Disp
_DW
_WSoft
_DF
- CBasin
- San. Sewer
_Lav
_WC
_FDr
- LTub
-SP
-Ur
- Storm Sewer
_Water
_Sink
Other
Eject
_SS
C? c.-- 1-1 CI 9:.--/1
~ Permit Fee Paid $ - l' ~ Park Dedication $
Date If.-;;L $' - F7 Final/O.P. J - I [{'- :;rg-
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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ADDRESS
TELEPHONE #
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PERMIT NO. ()7r¡;:~ APPL. DATE J?-/r~'7'JT
~:~ CONTR. ~~
7!9-~
ADDRESS
NATURE OF WORK
ELEC. SERVo NEW
DESC. TYPE? Ci/ ~
ÆIX~S SW"S
APPLIANCES
TEMP.
AMPS,{7 Q
CIRC"Sk
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SERVIC ;Jf -/. -~g FINALJ-~
PERMIT FEE ~~DATE PD.
§IGNS
INSP. ROUGHIN ð <
EST. COST S Ó ~
REMARKS