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CITY OF OSHKOSH N ° - 45071
PERMIT — APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 42. Aid �+ PLAN NO.
OWNER NOt9t__.. 1 L /--
DESIGNER p— S
USE/NATURE OF WORK - Z .
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BUILDING CONTRACTOR KtPptedeirr
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
c/
FEES: Valuation _ 7 er ' � j e Paid $ r'' Park Dedication $ �—
ISSUED BY I EM I II ! A f Aird Date ® Final /O.P.
In the performance • it work I agree t rform all work pursuant to rules governing the described construction.
41111P SIGNATURE ( .. .5' o�/ 9 c
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AGENT/0 NE
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ADDRESS /6 OS /L 0,S‘ G' f- . .3 / s , 5
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