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CITY OF OSHKOSH N ° - 37820
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 81 SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS 47 fl C PLAN NO.
OWNER K 4iiid-g-k
DESIGNER
USE /NATURE OF WORK ) EA) 7
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 fa,V)iKfl?JYt4
BT L WH Disp WSoft CBasin
- Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
- Sink LTub Eject SS Water
Other
dt: 0
FEES: Valuation $ 5 Permit Fee Paid $ / Park Dedication $
ISSUED BY Date fem.i Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
• ENT /OWNER DATE
ADDRESS
TELEPHONE #