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PERMIT - APPLICATION AND RECORD CITY OF OSHKOSH N~ 20273
Address ~/7 ß -¿Ii w / ';,/ . Owner ¡1J¡'c ¡;?L Q ¡ /10 (/ ;7 f' Id. No.
Lot Block - Ward- Subdivision Zoning- Parkland Dedication Fee Flood Plain
Type of Permit: Building 0 Electrical 0 Heating 0 Plumbing 1& Sign 0 Wrecking 0 Fence 0 Pool 0 Occupancy Permit Required Permit Date dj-~
Nature of Work ~ v...> t;J"O./(-~..¡- <:"" i> t~r "'- if~ BUILDING Use ..::>; --~Jlo, ~~~: <
~
OSHKOSH
General
Siding
Type of Construction
PLUMBING CONTRACTOR
Bu. San. Sewer - Curb to Bu.
Bu. St. Sewer Curb to Bu.
Foundation
Size:
_feet wide X
feet long
Square feet area
Main to Curb:
Main to Curb
Height:
Stories and Basement
above Grade
I-~t.
]
~t.
No. of Rooms
Mason -
Carpenter
Architect
-
Inspections -
Footing Foundation
~ \ Electric Service R.I.
t Sewer Water Service
å
Final
Width of Lot
Sewer Fees
l
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 C:~M - Total Fees
- 5t)
HEATING CONTRACTOR
Fuel: Gas D Oil DElee.
Conditioning Forced Air D
System High Eff. D
Chimney: "A" D "B" D
Calculated Heat Loss
í
D Solar D Solid D
H.W. DElee. Base D Steam D Radiant D
Supplementary D Air Condo D Ventilation D
Direct Vent D Con. Burner D Flue Damper & E.I. D
System BTU Rating
Estimated Cost ./t y -/ ó ¿) Fees Paid $J - ;\0 " Date
TO THE BUILDING IJS EC';:-OR: ;n accordance with Section 7-18 of the Municipal Code of the City of Oshkosh, it fs agr{ed 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, or wire fence not less than
five feet in height shall be erected all around such excavation. Such barrier, wall or wire fence will remain in position until removal is approved 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) Phone
:::¡:~t~l ~ II ~ Agent
Electrical Signs
Address
Phone