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CITY OF OSHKOSH N°- 39939
PERMIT -APP
LIGATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS
# Stories Height .
Class of Const. Occupancy Permit
OWNER~~3L 7~C~L[.P
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft.
Foundation
# Rooms
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR ~~C.C,ee~~
Electric Serv. New ^ Change~Temp ^ Type - //~'" Volts3~ Amps ~ 0
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
FEES: Valuation a ~ ~ ~ a Permit Fee Paid $ 3-~• ~ ~ ~ Park Dedication $
ISSUED BY ~~ Date ~ 3 Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER
PLAN NO.
DATE
ADDRESS
TELEPHONE ~