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CITY OF OSHKOSH N °_ 34441
PERMIT - APPLICATION AND RECORD
TYPE: BLDG )k HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS E30 /' (i - PLAN NO.
OWNER
DESIGNER Q �2
USE /NATURE OF WORK // '�t 2 - G� I�CP . 7Gt1 l(, .+. , /3�,(/2-7?-.. l,)
te o DM- , aWo D *i. rE
BUILDING CONTRACTOR /1•77 j .
Size Sq. Ft. # Rooms # Stories Height
F r Foundation Class of Const. O Occupancy Perm
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
BT _ WH _ Disp — WSoft _ CBasin
__Lay _ Sh _ DW _ DF _ San. Sewer
— WC FDr SP Ur Storm Sewer
Sink _. LTub _ Eject _ SS _ Water
Other
/
FEES: Valuati n $ 3 4o D 0 Permit Fee Paid $ )-0-00
n Park Dedication $
ISSUED BY Date 40z3/jc3 Final /O.P. 12/.2 e l 93
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 2 .
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
O 1ER A -, RESS P?(-) Pr / 9,06 CT
DATE PERU # : U SFR
6 , / 2 _ -rk consists of
GENERAL CO RAC R — f
MASON CONTRACTOR ZONE
Width of lot DATE INSPECTIONS
n REMARKS
34 711
L/:N I r SW C S O 2 chrZ
V 1 Th'W (a2J6/Aw L) n.) r ,t
4 O (_– ) (A) (T1-( fit V6 7711 ld.�t.)) r ./1 /+.e
.2 12 3�', - l�l'.�./dc 1
V
O /.-1
C14
0
A
Front of lot MAILING ADDRESS