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CITY OF OSHKO,SH N2
PERMIT - APPLICATION AND RECORD
06698
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ADDRESS
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PLAN NO.
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OWNER
DESIGNER
USE/NATURE OF WORK
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BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
, # Stories
Class of Const.
Height
Occupancy Permit
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Foundation
HEATING CONTRACTOR
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Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
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ELECTRIC CONTRACTOR
Electric Servo
New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
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_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF ~tl
+ San. Sewer ~Vc
_WC _FDr _SP _Ur -I- Storm Sewefl 'f jtJV L
_Sink _ L Tub _ Eject _SS I- Water / '-( r-7~
Other
FEES, Valuat"n Z~ '" .
ISSUED BY" 0.9'2---
1
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Pe,mll Fee Paid $ ~ 6.
Date OL /;29.
,
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
CbIt /~
~ . (j " " AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
PEm1IT#F
ADDRESS
OWNER
NAtURE
4F
INSPECTION
DATE
INSPECTION
DATE
Pipe
1** Violation notes. on the reverse sidel
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