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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N2
04833
TYPE:
BLDG 0 HTG 0 ELEC 0 PLBG ø SIGN 0 ZONING - FLOOD PLAIN - HEIGHT-
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
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PLAN NO.
ADDRESS
OWNER
DESIGNER
USE/NATURE OF WORK
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BUILDING CONTRACTOR
Size
FOlj 1dation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Ciass of Canst.
HEÃTING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRiC CONTRACTOR
Eiectric Servo
New 0 Change 0 Temp 0
Type- Voits- Amps-
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR M A/ >
~ BT --L WH L Disp
2-Lav _Sh ~DW
-.3:wc -LFDr -Lsp
-LSlnk -/-L' _Eject
Other
_WSoft
-DF
- CBasin
- San. Sewer
-Ur
- Storm Sewer
_SS
_Water
FEES: vaiuation~ cc:z.-- ./
ISSUED BY ~
I
Permit Fee Paid $ -3.( ~.¡
Date g- .( -,F?
Park Dedication $
Final/O.P. ~ลกþ
In the performance of this work I agree to perform ali work pursuant to ruies governing the described construction.
SIGNATURE
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AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
OWNER
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c!- A b (5 fiA--"Í -/; Iê LA-.I Co II
P ERMlT II
O'fó"3?
ADDRESS
NATUREOFWORK
PLUMBER
W A-r'ih2J
<.¥.
INTERIOR 3fc<:::>""
II New Relay ReDair II II
I ¿on Sew ";} Bathtub I Ca t ch B.
Water ;¡ Lavatory II Grease T.
St. Sew 'ì Toilet II I Sumo P. I
**Inspection Date: I Sink Ki t. I Local Was te
(). L '8/(1 ~~/ Sink (other) Site Drain
Showe r I I Laun d ry I
;41e!cÞ~ éJ'UI--;;/~F/ø ) Floor drain ¡Laundry tray
"J Disposal W. Softner
f 3(r/;(ø. Dishwasher D. Fountain
/ vJ-;-;'"Z- 1---/"1"'-"Z II
**Violation notes on reverse side
OUTSIDE