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CITY OF OSHKOSH N° 39475
PERMIT - APPLICATION AND RECORD
TYPE: BLDG 0 HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 930 ,WE2S PLAN NO.
OWNER ROB - OCT C. ElAJ /,S
DESIGNER
USE /NATURE OF WORK S ) . (ACE tW IS77/06 f � -C/� D S'
wrrii V LL FRE - 0,4 s7 ! A.u, - r:
BUILDING CONTRACTOR 1141U–D' Z —C14577
Size Sq. Ft. # Rooms # Stori s 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
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
1 42- FEES: Valuation $ I 4 ' Permit Fee Paid $ �d� Park Dedication $ '�
ISSUED BY 4 1 ■ Date SAY/ 9 5 1 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ,' _4411'/ i r- J�Z 1 LC/7 ,
A ENT/OWNER ATE
ADDRESS 7 6=a4E)60 ag,_6--__8-78--
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