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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
02812
TYPE: BLDG D HTG D ELEC D PLBG ~IGN D ZONING FLOOD PLAIN HEIGHT
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DESIGNER
USE/NATURE OF WORK
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BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
-L BT -I- WH
2Lav +Sh
~C ~ FDr
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-I-Sink -LL~
L:~, /~C:3
-I Disp
+DW
+SP
_ Eject
_ WSoft
_DF
_ CBasin
_ San. Sewer
_Ur
_ Storm Sewer
_SS
_ Water
Other
.FEES: Valuation $
ISSUED BY
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~'J ~.. Per . 'Fee Paid $,
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Park Dedication $
Final/O.P. 3 /17 /'g7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
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AGENT!OWNER
DATE
ADDRESS
TELEPHONE #
PLUMEER
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PLUMBING PERMIT APPLICATION
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ADDRESS ~.Jy~ )' (fe;, 12 r./.r;~-;r~
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NAME OF OWNER
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NEW SAN. WATER STORM RET"-i\,Y -- SAN. WATER STOfu"1
Main to Curb Main to Curb
Curb to Bldg. Curb to Bldg. . '
Elect. Pumps Repair
Septic Tanks
.. NEW REP. / / . NEW REP. NEW REP. i
Bath Tub Gar. Disposal Catch Basin
Wash Basin Dishwasher Conductors
Water Closet Laundramats Grease C.B.
Sink Water Softener Sump Pump
Water Heater San. Bubblers Bar Wastes
Shower Bath Urinals Range Boiler
Floor Drain Dental Cuspidors Future Outlets
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