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CITY OF OSHKOSH N° 45371
PERMIT - APPLICATION AND RECORD
TYPE: BLDG.h,-HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS l 1 al � XD PLAN NO.
OWNER N "I" SoarO,
DESIGNER n
USE/NATURE OF WORK C,cLV� �,r9�ts2r- o� -ft° r+�,►..�1 ��
BUILDING CONTRACTOR
Siz A " - Sq. Ft. # Rooms # Stories Height
Foundation tX(4_ Class of Const. A— Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR a^ell-
Electric Serv. New ❑ Change ❑ Temp ❑ Type
Fixtures Switches Receptacles,
PLUMBING CONTRACTOR
— BT
— WH
_ Disp
—Lav
—Sh
—DW
— WC
— FDr
— SP
— Sink
— LTub
_ Eject
Other
Volts Amps
— Circuits
—. WSoft — CBasin
DF —San. Sewer-
- Ur —Storm Sewer
SS —. Water
FEES: Valuatio $
it Fee Paid $
Park Dedication $ - -----
ISSUED BY
Date
Q3
Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules aovernina the desrrihad rnn_Qtmrtinn
-6-:Z �_
DATE 170
TELEPHONE i
t
OWNER
DATE & 4 S PERMIT # L%5-37
GENERAL CONTRACTOR
O
r4
w
O
y
d
m
A
MASON CONTRACTOR
Width of lot
NV
140T OUT
Front of lot
ZONE
ADDRESS G <7 S"A4..4jQ IA�o JIG
USE Sr—
Work consists
DATE
� ss
F—m-
RKS
MAILING; ADDRESS