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CITY OF OSHKOSH N ° - 40324
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS \ 1 t m o (L PLAN NO.
OWNER al.ON6
DESIGNER cJ(
USE /NATURE OF WORK U)CL ' ra
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 ` lffl YbaM
BT WH Disp — WSoft CBasin 0G,1
- Lav Sh DW DF San. Sewer
- WC FDr — SP Ur _Storm Sewer
— Sink LTub _ Eject — SS — Water
Other
FEES: Valuation $ 44(OA Permit Fee Paid $ `0. Park Dedication $
ISSUED BY Date 9 / — Q7 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
V ,.
SIGNATURE
AGENT /OW ER DATE
ADDRESS
TELEPHONE #