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CITY OF OSHKOSH N°— 41394
A PERMIT -- APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 1-71 —7 ezt U". 'A. -e--),-' PLAN NO.
OWNER 1U44 ( i.. fit/ /<
DESIGNER
USE/NATURE OF WORK
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 i LC),tG( /6 Att u � 4.42-e-- f ,�" '`� '`"ti"zc.r
Electric Serv. New ❑ Change Temp ❑ Type Volts Amps ci}
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: Valuation $ Cf cP L' Permit Fee Paid $ 5 0� Park Dedication $
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ISSUED BY E= '" /,. Date ;)/7 l l�/. Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE L,/ -t--- v /
AGE ER R
DATE
ADDRESS TELEPHONE#