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N2 35979
CITY OF OSHKOSH
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC BG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS j v PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK 47"
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 �ype Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation SO o o Permit Fee Paid 0 0 Park Dedication
ISSUED BY ���7i r� Date 9 /5 43 Final /O.P. ?I ,5n/93-
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
r TNWNER DATE
ADDRESS
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