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CITY OF OSHKOSH N ° - 45589
4 PERMIT - APPLICATION AND RECORD
CO RD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS //0_4/. c )�. e �,.. PLAN NO.
OWNER -0 ,/` e 7e-
DESIGNER 4 l USE/NATURE OF WORK 42/ e,2-41 \ " i ir1
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 J'"1442(
- BT _ WH _ Disp _ WSoft _L CBasin
Lav _ Sh _ DW _ DF — San. Sewer
- WC _ FDr _ SP _ Ur / Storm Sewer / -2 r, P V
- Sink _ LTub _ Eject _ SS — Water
Other
FEES: Valuation $ �a Permit Fee Paid $ /9 Park Dedication $
ISSUED BY Date / ..Z //95 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 8:(2.'1, 5 3 3 (p 2 I 5
c 11 �,// W AGENT /OWNER �( DATE
ADDRESS v ? �" ` VI/ (4 v k G C1 O I V (236--333
TELEPHONE #