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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
17308
TYPE: BLDG D HTG D ELEC D PLBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
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Delt
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PLAN NO.
ADDRESS
DESIGNER
USEJN~E OF WORK _~: Ie (
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BUILDING CONTRACTOR 'J::>
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Foundation :1E "t: f ~f-
# Stories
Class of Const. 8
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Height
Occupancy Permit
(ce-rfl
HEATING CONTRACTOR
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Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
R-v- c... (<::-
Electric Servo
New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
1?:.
.
_Lav
_WH
_Sh
_Disp
_DW
_SP
_ WSoft
_DF
_ CBasin
_BT
_ San. Sewer
_Sink
_FDr
_ L Tub
_Ur
_ Storm Sewer
_WC
_ Eject
_SS
_ Water
Other
In the performance of this work I a ree to perform all work pursuant to rules governing the described construction.
Fee Paid $
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Park Dedication $
Final/O.P.
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FEES: Valuation
ISSUED BY
Date
SIGNATURE
AGENT/OWNER
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TELEPHONE #
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