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~W ~~~~ Address
PERMIT - APPLICATION AND RECORD
¿Ç-O W. J./!h 5'r~
Building 0
Electrical 0
Ward
Heating œ> Plumbing 0
CITY OF OSHKOSH
- Owner Ie rrj },,/t//t¡r
Subdivision
N~
12886
Nature of Work
Sign 0
Wrecking 0
Occupancy Permit
Zoning
Insp.~¥' .
Id. No.
Flood Plain
Permit Date ¿;~/ 3"3
Lot
Type of Permit:
Block
BUILDING Use
e5
General
Foundation
Siding
Type of Construction
PLUMBING CONTRACTOR
Bu. San. Sewer - Curb to Bu.
Bu. St. Sewer Curb to Bu.
Size:
_feet wide X
feet long
Square feet area
Main to Curb:
Main to Curb
Height:
Stories and Basement
feet above Grade
Width of Lot
No. of Rooms
Sewer Fees
-------1t.
Mason
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
Carpenter
Architect
-------1t.
Inspections -
Footing
Foundation
.3 I Electric Service
R.I.
HEATING CONTRACTOR T ee{ 0 - /L eM J/'1 é" h
Fuel: Gas ¡;¡g¡ Oil 0 Elec. 0 Solar 0 Solid 0
Conditioning Forced Air ¡g H.W. 0 Elec. Base 0 Steam 0 Radiant 0
System High Elf. 0 Supplementary 0 Air Condo 0 Ventilation 0
Chimney: "A"f5Þ "B" 0 ,Direct Vent 0 Con. Burner 0 Flue Damper & E.I. 0
Calculated Heat Loss .E:"jt57'lht System BTU Rating /t?'7:?, ~
"õ
~ I Sewer
0
Water Service
Estimated Cos~ . t?t:) Fees Paid $,,-,-PO
TO THE BUILDING I PECTOR: In accordance with Section 7-18 olthe Municipal Code olthe City of Oshkosh, it is agreed that ilwork shall be
discontinued for a period of 30 days at anytime for any cause after excavation work ¡scommenced, a solid barrier, wall, orwire fence not less than
live feet in height shall be erected all around such excavation. Such barrier, wallar wire fence will remain in position until removal ¡sapproved by the
Building Inspector.
ELECTRIC CONTRACTOR
Electric Service: New
Description-Type
Fixtures-
Appliances
Changes
Temp.
X
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.
Switches
Volts
Recep's
Amps
Circ's
(Signed)
Electrical Signs
Phone
Agent
Phone
Ø1b
ADDRESS
OWNER
NATURE
HEATING CONTRACTOR
FUEL: @ OIL
ELEC
-el'"'
SOLID
/
/
CONDITIONING }fORCED AIR H.W. ELEC. BASE STEAM
SYSTEM GRAVITY SUPPLEMENTARY AIR CONDo
CHIMNEY: @ "B" DIRECT VENT CON. BURNER
CALCULATED HEAT LOSS G:<¡,f'>; ì'/.., <¡ SYSTEM BTU RATING
MISC. t
INSP. ROUGH IN FINAL
EST. COST!JI?-ðtJ- ¡?OPERMIT FEES $,<
REMARKS 7