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CITY OF OSHKOSH N° 32603
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG tfp ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 1,-6 r 4.217 /4'/ kit
PLAN NO.
OWNER el 5 6/05
DESIGNER
USE /NATURE OF WORK 11 k' G Ilea, P>tts. m e-
BUILDING CONTRACTOR
Size Sq. Ft. Rooms Stories
Height
Foundation Class of Const.
Occupancy Permit
HEATING CONTRACTOR_ J1 Yi e C(/ -e- N 1
Heat fel A/C Vent Fuel /System /1G -4 Heat Loss OF ftipp BTU'S 0 Uv'fl
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
FEES: Valuation 2 d� permit Fee Paid 4„, I
Park Dedication
ISSUED BY Date 5/4093
Final /O.P. Lo f3
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
1114
AGEN /OW R g -3
ATE
ADDRESS r ze
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