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CITY OF OSHKOSH N2-47548
PERMIT - APPLICATION AND RECORD
TYPE: BLDG i HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 6/ / L c� t
PLAN NO.
OWNER `l NAi fTX /-v jf/; i2
DESIGNER
USE /NATURE OF WORK / /rU , Ilk' i' i 017; / - 12 1
i
BUILDING CONTRACTOR C4/t eh
Size Sq. Ft. # Rooms :iA i;r, # 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
FEES: Valuation $ _T` ■O • Permit Fee Paid $ • 4a Park Dedication d cation $
ISSUED BY G;
1� Date 10 '
v Fi nal /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 10-0—'"94—
d J '"S f'
AGENT/OWNER DATE
ADDRESS 4 0 6449 mi¢N`TdwdQ /' f K NeAmiJ74I1 4 01 . 7(j/' 9/l y
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