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CITY OF OSHKOSH N ° - 46409
PERMIT — APPLICATION AND RECORD
TYPE: BLD4CHTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS `7 '7 it-fa k_11 e° L PLAN NO.
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OWNER G-- f!°' f-- /L k h
DESIGNER / USNAT WORK -I � / ke h& 9s eQ, f` . c C -�-t rw– y C it cr t� f 'e js (a.e a 7 c c., ft e� )1 d r' 7
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BUILDING CONTRACTOR (QuD frier --
Size Sq. Ft. # Rooms # Stories ( Height
Foundation Class of Const. 63 Occupancy Permit
HEATING CONTRACTOR .i Y h 1 • Cr -rr-r, eci_ hcr),) �,� ,,C
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR r r k4 r•—
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
2 .
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
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FEES: Valuation : •
P ermit Fee Paid $ Park Dedication $
ISSUED BY ror Date 7/ e f S
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~ia 1 , d E
G ENT /OWNER �
ADDRESS / ? 7 Alan/A/ EsD 4 t (S5/ # 'i vs/
TELEPHONE N