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~ CITY OF OSHKOSH N°- 46341
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ~ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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~~~.~- ~ U~~ Tit E~
OWNER. ~~ eK.G - SO {/O./ % '~'! S ~C i w
PLAN NO.
DESIGNER
USE/NATURE OF WORK ~~ .~C-
BUILDING CONTRACTOR
Size Sq. Ft,
Foundation
HEATING CONTRACTOR Z)~U~~S
Heat ^ A/C [~ Vent ^ Fuel/System _ Heat Loss f < ~~ BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type Volts
Fixtures Switches Receptacles Circuits
Amps
PLUMBING CONTRACTOR
- BT - WH - Disp - WSoft - CBasin
- Lav - Sh -- DW - DF -San. Sewer
- WC - FDr _. gp _ Ur -Storm Sewer
-Sink - LTub -Eject - SS -Water
Other
FEES: Valuation $ 1~• Permit Fee Paid $ ~ 9~ ~~ Park Dedication $
ISSUED BY Date~~~~_ Final/O.P. 1 L ' ~~ " 9~
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNA'
AGENT/OWNER
ADDRESS
# Rooms # Stories Height
Class of Const. Occupancy Permit
ATE
TELEPFIONE N