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~~
~~~ Address
PERMIT - APPLICATION AND RECORD
t 77 l&.u "?rd 5ir'
CITY OF OSHKOSH
- Owner Oq/"u' J)"",¿;.i«?~r
~ ~ . /
SubdivIsion
Lot
Type of Permit:
Block
Ward
Heating I)a>
Plumbing D
Sign D
Electrical D
Nature of Work
PLUMBING CONTRACTOR
Bu. San. Sewer - Curb to Bu.
Bu. St. Sewer Curb to Bu.
Main to Curb:
Main to Curb
Sewer Fees
Water Service
Bath Tub Floor Drain Urinal
Wash Basin - Garbage Disp. - S. Sink
Water Closet - Dish Washer - Catch Basin
Kit. Sink Laundry Mach. - S. Pump -
Water Heater - Water Soft. B & S Waste -
Shower Bath - Bubbler Conductors
Plumbing Fees Total Fees
HEATING CONTRACTOR
Fuel: Gas D Oil D Elec. I}Þ iólar D- Solid D
Conditioning Forced Air D H.W. D Elec. BaseR Steam D Radiant D
System High Elf. D. Supplementary D Air Condo D Ventilation D
Chimney: "p.:' D "B" D Direct Vj mt D Con. Burner D Flue,Damper & E.!. D
Calculated Heat Loss II-f I1HI'WI/.4!'eI' System BTU Rating
ELECTRIC CONTRACTOR
Electric Service: New
Description-Type
Fixtures-
Appliances
Changes
Temp.
Amps
Circ's
Volts
Recep's
Switches
Electrical Signs
N~ 13880
Id. No.
Zoning w: Flood Plain
Insp. ~ 'Permit Date 7/P-ð/3'3
Wrecking D
Occupancy Permit
BUILDING Use
j)V//F;L
General
Roof
Foundation
Size:
_feet wide X
feet long
Height:
Stories and Basement
Width of Lot
I----ft.
~t.
Siding
Type of Construction
Square feet area
feet above Grade
No. of Rooms
Mason
Carpenter
Architect
Inspections -
Footing
~ I Electric Service
t Sewer.
Q
Foundation
R.!.
Estimated Cost { ,,(;lV. ([70 Fees Paid
TO THE BUILDING INSPECTOR: In accordance with Section 7-18 of the Municipal Code of the City of Oshkosh, it lagreeðÍhat ilwork shall be
discontinued for a period 01 30 days at anytime for any cause after excavation work !scommenced, a solid barrier, wail, orwire fence not less than
live feet in heightshail be erected ail around such excavation. Such barrier, wail orwire fence wiil remain in position untii removal is approved by the
Buiiding Inspector.
In the performance of this work the undersigned agrees to abide by and do work pursuant to all statutes, ordinances,
codes, and rules governing the described construction,
(Signed)
By
Address
Owner
Phone
Agent
Phone
PERMIT NO. ~ J J Y'7f'O APPL. DATE_4~d'3/¡¡:3
ADDRESS ¿ 77Ú/. 3 rd '3,
OWNER (-741':1 V -ec),t. -e Y>
NATURE OF WORK J.j ea 'fr'h r A//!Ú / }) (/ (J ) t> X
HEATING CONTRACTOR C~¡Wf 5t7Jeð-~
FUEL: GAS OIL L SOLAR SOLID
CONDITIONING FORCED AIR H.W. )a,EC. BASE STEAM
SYSTEM GRAVITY SUPPLEMENTARY AIR CONDo
CHIMNEY: .., "B" DIRECT VENT CON. BURNER
CALCULATED ~EAT LOSS~ 14-"0""'" ,,~jSYSTEM BTU RATING~
MISC. ,.. ,y '/
INSP. ROU¡;¡¡ IN FINAL t? ?
EST. COSTffbOÔ.<?OPERMIT FEES;/C.O D TE PD
REMARKS
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