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CITY OF OSHKOSH N2-48414
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG 04 SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS JO9r� 5 Ar Atc0. I Ve PLAN NO.
OWNER ioOlVld N. wean
DESIGNER
USE /NATURE OF WORK /Jf k Jf(' �Ude!
BUILDING CONTRACTOR
Size Sq. Ft. Rooms Stories Height
Foundation Class of Const. Occupancy Permit
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 Cf I IJ'V 1?S 1 .A
BT 1 WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation Pere' Fee Paid 10 Park Dedication
ISSUED BY Date /2„,"
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE` nsa■_
AGENT /O ER DATE
ADDRESS
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