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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N2
00246
TYPE:
BLDG D HTG D ELEC D PLBG pi, SIGN D ZONING
FLOOD PLAIN
HEIGHT
DESIGNER
PLAN NO.
ADDRESS
OWNER
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USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
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
t<;(" -/t ~- t
_BT
_WH
_Sh
_Disp
_OW
_SP
_ WSoft
_OF
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4t7,rcrL
_Lav
_ San. Sewer
_WC
_FOr
_ L Tub
_Ur
_ Storm Sewer
It{
_Water CcYr~-
_Sink
Other
_ Eject
_SS
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FEES: Valuation $ 'JO zJ . . Permit Fee. Paid $
ISSUED BY ~~~/"'----------' Date
/
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Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE \( ;/)''',
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, DATE
AGENT/OWNER
ADDRESS
TELEPHONE #