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CITY OF OSHKOSH N° 35296
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGX SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS CU d M , naava PLAN NO.
OWNER Foyi- ,c ehWo fr -i"Z
DESIGNER V
USE /NATURE OF WORK . 1..0
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
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR >461/7 >461/>461/7 7 m4J?
V
BT ,1 WH Disp WSoft CBasin a
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ 530. c ^^__ Permit Fee Paid $ J� • 0-1) ^� Park Dedication $
ISSUED BY ) 2?/J, *I_ Date 1 'S i. Final /O.P.
In the performance of this work 1 agree to perform all work pursuant to rules governing the described construction.
.....) 04 __________.,
SIGNATURE c
AGE /OWNER DATE
ADDRESS
TELEPHONE #