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CITY OF OSHKOSH N2 - 41542
PERMIT - APPLICATION AND RECORD
TYPE:
BLDG..l5fHTG D ELEC D PLBG D SIGN D ZONING - FLOOD PLAIN- HEIGHT-
- - - - - - - - - - - - - - - - - - -.................................................
ADDRESS
. 1013 .I3rJdl w ¡PI. ~ It<:
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PLAN NO.
OWNER
DESIGNER
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USE/NATURE OF WORK
BUILDING CONTRACTOR
@4>M-er
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Canst.
HEATING CONTRACTOR
Heat D NC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
New D Change D Temp D
Type - Volts - Amps-
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT
_WH
_Sh
_Disp
_OW
_WSoft
_OF
- CBasin
_Lav
_WC
_FOr
_LTub
_SP
_Ur
_SS
- San. Sewer
- Storm Sewer
_Sink
-Eject
_Water
Other
ISSUED BY
Park Dedication $ --
Final/O.P.
In the performance of this work I agree to erform all work pursuant to rules governing the described construction.
$\6NATUR-/! j~,-~ Leu.
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0/9/9¿j
DATE
c2 .35- 33<-0/)
TELEPHONE #