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Address
PERMIT - APPLICATION AND RECORD
t~:¿I- 1021 A 7V'J-~
Ward
CITY OF OSHKOSH
- Owner c?i-~~ ø-~~
Subd ivision
-
Lot -
Type of Permit:
Block
Building 0 Electrical,ø
N~
3441
Occupancy Permit ..1t..
Zoning
Insp'.
Id. No.
Flood Plain
Permit Datek/...<- 79"
Wrecking 0
Heating 0
Plumbing 0
Sign 0
BUILDING Use ~ /h~ ~ -"7/'PA /.(- ~~
General Cont.
Roof
Siding
Type of Construction
Foundation
Size: - feet wide X
feet long
Sq uare feet area
Height:
Stories and Basement
above Grade
Width of Lot
No. of Rooms
l
Mason
Carpenter
Architect
I ft.
1- I
- -----'t
I
I
.3
0
Water Service
Inspections -
Footing Foundation
9-1"« .u-f.
Electric Service/l"-.2 f,-7'J R.I.
-----'to
19-80
Sewer
"1
~ ~
Estimated Cost . DO....- Fees Paid / 7'. u" - Date
,
TO THE BUILDING INSPECTOR: In accordance with Section 7-18 of the Municipal Code ofthe CityofOshkosh. it is agreed that if work
shall be discontinued for a period of 30 days at any time for any cause after excavation work is commenced. a solid barrier. wall, orwire
fence not less than five feet in height shall be erected all around such excavation. Such barrier. wall orwlre fence will remain in position
until removal is approved by the Building Inspector.
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.
l
ISigo"l ~
Addre~ -~----- Agent
By (",hoci,,' Sigo"",,)
Owner
Address
Nature of Work
PLUMBING CONTRACTOR
Bu. San. Sewer - Curb to Bu.
Bu. St. Sewer Curb to
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 0 OilD Elec.D Solar 0 Solid 0
Conditioning Forced Air 0 HW. 0 Elec. Base 0 Steam 0
System Gravity 0 Supplementary 0 Air Condo 0
Chimney: "A" 0 "B" 0 Direct Vent 0 Con. Burner 0
Calculated Heat Loss System BTU Rating
ELECTRIC CONTRACTOR ;;;t;;~ ~--.ß::...;--"
Electric Service: N<;¿, .. C/ Chan.geS ~/~cJ4-!;:~emp.
Description-Type- :> ~ cZ~~ Volts -..2-)L<\ Amp~
Fixtures Switches Recep's ¿- Circ's ¡;.---
Appliances
Signs