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~ PERMIT - APPLlC~TION AND RECORD dlTV OF OSHKOSH
OSHKOSH Address ;< S' Y " ~ u k - ~ Owner cy ð/?? ~
~ Block- Ward- Subdivision Zoning- Parkland D aication Fee Heigh!,l.~¡~t-
Type of Permit: Building D Electrical Ii( HeatinQ n Plumbina n Sign D Wrecking D Fence D Pool D Occupancy Permit Required /rØ-, Insp.~
N~
22114
Nature of Work
Id. No.
Flood Plain-
Permit Date IL:1[ -g5
-~~-M
BUILDING Use
¿f~
General
Roof
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 oILo'
No. of Rooms
Sewer Fees
----'I
Mason
I
ì
!
.
r
i
¡
!
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
----'I
Inspections -
Footing
Foundation
Electric Service
HEATING CONTRACTOR
Fuel: Gas 0 Oil 0 Elec. 0 Solar 0 Solid 0
Conditioning Forced Air 0 HW. 0 Elec. Base 0 Steam 0 Radiant 0
System High Eft. 0 Supplementary 0 Air Condo 0 Ventilation 0
Chimney: "A" 0 "B" 0 Direct Vent 0 Can. Burner 0 Flue Damper & E.I. 0
Calculated Heat Loss System BTU Rating
1
Sewer
R.I.
~witches
-- Volts
~ Recep's
Temp.
("-,.., - Amps
--==::..=-eire's
Estimated Cost 'Ø J 2f 0'::::"-'----- Fees Paid <;r /,) ~. Date II - g - "2 5"
TO THE BUILDING INSPECTOR: In accordance with Section 7-18 of the Municipal Code of the City of Oshkosh, it is agreed that if work shail be
discontinued for a period of30 days at anytime for any cause after excavation work is commenced, asolid barrier, wail, orwire fence not less than
five feetin heightshail be erected ail around such excavation. Such barrier, wail orwire fence will remain in position until removal is approved by the
Building Inspector. 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.
ELECTRIC CONTRACTOR
Electric Service: New
Description-Type
Fixtures-
Appliances
(Signed)
Electrical, Signs
Address w Phone
By ~ a-/ ~~ ~ Agent
(A",ho""d s;""7 /
Address Phone