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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
14482
TYPE: BLDG D HTG ~ ELEC D PLBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
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OWNER
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13/5-n?orL
LV 1'5;7 /f1. /L-
PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
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5'- I? (j2 ~
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR cla r l' auf '~
t Heat 0 AlC Q<P Vent 0 Fuel/System ';T/'<U ';j-
Heat Loss j3:'~( (5 / BTU'S
~ 72Y F',
ELECTRIC CONTRACTOR
Electric Servo
New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
FEES: Valuation $ I ;?:?'z:;J. t~
ISSUED BY ~~
I
Permit Fee Paid $ ,J-? < ~ V
Date 7/ /<?;f ?9
Park Dedication $
Final/O.P. '6.-:2(-?f
In the performance of this work I agree to perform all work pursuan~ ~o rules governing the described construction.
SIGNATURE
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AGENT/OWNEV
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ADDRESS
TELEPHONE #