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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
24948
TYPE: BLDG D HTG ~ ELEC D PLBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
ADDRESS
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P Yh Un d<l'.rtu./tJ?G4
PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
Mcll1-/r
t3, F 62ec;
,
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
r:
HEATING CONTRACTOR ~ar Jrh..-QI1 UYzr
Heat D AlC D Vent D Fuel/System F / of" c- 1-
Heat Loss C'P /7 r
BTU'S 1.0- J'z?/? Q-/C.-.
ELECTRIC CONTRACTOR
Electric Servo New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
'PLUMBING CONTRACTOR
_BT _WH _Disp
..
_Lav _Sh _DW
_WC _FDr _SP
_Sink _ L Tub _ Eject
Other
_ WSoft
_DF
_ CBasin
_ San. Sewer
_Ur
_ Storm Sewer
_SS
_ Water
FEES: Valuation $ I fI 00, O(!'J
ISSUED BY ~...,J
Park Dedication $
Final/O.P. q - I b .- q }
,
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
J}~ '
~ER
~~/9/
'DATE '
ADDRESS
TELEPHONE #