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CITY OF OSHKOSH N2-48133
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 3/ �- , - -", 2 _-
PLAN NO.
OWNER IR
DESIGNER �/
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USE /NATURE OF WORK / S " .' ,
t
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 P Circuits
PLUMBING CONTRACTOR ..... /4--71..----,---
BT -- WH — Disp _ WSoft
— CBasin
Lav — — DF �
Sh DW / 7 1 San. Sewer () C--
WC — FDr — SP — Ur ( � J c
Storm Sewer
Sink LTub — Eject — SS Water /t_
ti.,...__
Other
FEES: Valuation $ 45-(3 00 36 p G /
Permit Fee Paid $ Park Dedication $
ISSUED BY Date / P 5" Final /O.P.
In the performanc of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /C. /��.� O
AGENT /OWNER /91-
/
(� � 1 DATE
g� " ""� � vC.c7 � L
ADDRESS Ali �,�..� 6 ci5
TELEPHONE #