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CITY OF OSHKOSH N2 35820
PERMIT APPLICATION AND RECORD
TYPE: BLDG.TG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS i/o ,Set.,_,›Dte /7 (V PLAN NO.
OWNER 0Let -f 10 P'.- f 1 a -s
DESIGNER �--y^
USE /NATURE OF P WORK �7 E' 51 /IUt�„ tope, q r
J1 s �l
BUILDING CONTRACTOR /0 c
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
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
,--44/
FEES: Valuation t.0 P: a' Fee Paid P::1:ti0n1
P.
In the performance o this work I agree to arm all work pursuant to rules governing the described construction. f
SIGNATURE
9-3-63
/AGENT /OWNER
DATE
ADDRESS 70 3 Ni G4t.i 5; O i' 6
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