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CITY OF OSHKOSH N 39594
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG y ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 u 64 47 z°GIi y-/ 4"" .l� Way PLAN NO.
OWNER IU �j'Cl�l 6012',/ l
DESIGNER
USE /NATURE OF WORK 4 4- /le L!/ 46112
BUILDING CONTRACTOR
Size Sq. Ft. Rooms Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR r e e r G'- �i
Heat TpA/C 111 Vent Fuel /System AL 6.- Heat Loss J}5" fl BTU'S �i j Lle`i",
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
1
FEES: Valuation /0e. C Permit Fee Paid a-. Park Dedication
ISSUED BY `0 Date 5�-.4�/ y Final /O.P. 1,� 'IAA
In the performance of this work I agree to perform I work pursuant to rules governing the described construction.
J 1/
J i, L SIGNATURE 0y�
AGEN OWNER ATE
ADDRESS
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