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CITY OF OSHKOSH
N2 33044
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK
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
u•
OC J
Electric Serv. New ange Temp Type //l( Volt /s d Amps
Fixtures Switches Receptacles Circuits v
Oig
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 A Permit Fee Paid Park Dedication
ISSUED BY Date 3 Fi nal /O.P. b JIa /9 3
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR. /�fi g--- �3 /OWNER
ADDRESS
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