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N~ 39737
CITY OF OSHKOSH
PERMIT -APPLICATION AND RECORD
TYPE: BLDG ~ HTG ^ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
-------------------------------- -----------------------------------
ADDRESS ~~~ / ~~ ~ ST ` PLAN NO.
OWNER
CATNEIE'
DESIGNER
USE/NATURE OF WORK ~~~~" / 1 ~-S~ ~~- l ~~~~ ~ ~x~ ~~~
U ~~ rs. ~~1?O~/E EXsO S~,o ~iu6 ~ /tis;,tc.~ ~U~U U/~-1ClC
~i oiN~ ~ /NSuc . ,~v~p /4~c..~ Nov cvi~~ Coc%ZS.
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft
# Rooms
# Stories Height
Class of Const. ~ Occupancy Permit /V~
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
- BT WH Disp WSoft
Lav ~ -Sh -DW -DF
- WC _ FDr _ SP Ur
-Sink LTub Eject - SS
Other
CBasin
-San. Sewer
-Storm Sewer
Water.
p o9
FEES: Valuation $ Permit Fee Paid $ _ SS' ~ ~ Park Dedication $ r--
ISSUED BY Date ~ ~ Final/O.P. '-~
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~o -1-`~y
DATE
ADDRESS ~~ Co S ~.'1 ~~.,-.. ,~- ~ o73S - d) O b
TELEPHONE #