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CITY OF OSHKOSH
N9 33070
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG f J SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ?3 6 ig PLAN NO.
OWNER Z.-
DESIGNER
USE /NATURE OF WORK /4 H
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 p Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 2 .G—
- BT / WH _ Disp _ WSoft — CBasin
— Lav ._ Sh DW DF San. Sewer
WC _ FDr SP Ur _ Storm Sewer
- Sink _ LTub Eject SS _ Water
Other
S‘ 0 / c .. 0 U ✓
FEES: Valuation $ Permit Fee Paid $ Park Dedication $
ISSUED BY Se2 Date —/ 7 -93 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE � 3 /7— ' r ?
AGENT /OWNER DATE
ADDRESS
TELEPHONE #