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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N2
.02937
TYPE: BLDG 0 HTG 0 ELEC 0 PLBG)2i SIGN 0 ZONING - FLOOD PLAIN- HEIGHT-
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DESIGNER
USE/NATURE OF WORK
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BUILDING CONTRACTOR
Size
F,oundation
Sq. Ft
# Rooms
# Stories
Height
Occupancy Permit
Ciass of Const
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HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
New 0 Change 0 Temp 0
Type- Volts- Amps-
Fixtures
Switches
Receptacles
Circuits
_BT
_WH
_Sh
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- Disp - WSoft
PLUMBING CONTRACTOR
_WC
_FDr
_LTub
_DW _DF
_SP _Ur
_Eject -SS
- CBasin
_San. sewer----d-4/V(
- Storm Sewer Lf¿c ~V(
) (,
- Water ,~(7P/ 1/-
_Lav
_Sink
Other
ISSUED BY
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Permit Fee Paid $ .7-~.' ,
Date - /Ø~7
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Park Dedication $
Final/O.P.
FEES: Valuation $
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
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DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
PLUMBER ~ T Þ jC n:¿~q .~ DATE ./ / /'7~
NAME OF OWNER #;2sc.P:. ADDRESS J '5,-;:);' Ai Ie."" Áv-,.
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0;("137
~ J- $'.
NEW SAN. WATER STORM RELAY SAN. WATER STORM
,
Main to Curb Main to Curb
Curb to Bldg. Curb to Bldg.
Elect. Pumps Renair
Septic Tanks
s.
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NEW REP. NEW REP. NEW REP.
Bath Tub Gar. DisDosal Catch Basin
Wash Basin Dishwasher Conductors
Water Closet Laundramats Grease C.B.
Sink Wa ter Sof tener Sump Pump
Water Heater San. Bubblers Bar Wastes
Shower Bath Urinals Range Boiler
Floor Drain Dental Cuspidors Future Outlets