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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
01945
TYPE: BLOG D HTG D ELEC D PLBG 6a..SIGN D ZONING FLOOD PLAIN HEIGHT
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OWNER
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 NC 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
-1- BT -L WH
-J- Lav + Sh
-S WC +FDr
--J- Sink i Lfob
Other
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_Disp
-Low
--I- SP
_ WSoft
_OF
_ CBasin
_ San. Sewer
_Ur
_ Storm Sewer
_ Eject
_SS
_ Water
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· FEER Valuation ~ L Pe.mU Fee Pakl $
ISSUED BY ~ ~/ Date
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Park Dedication $
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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
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DATE
ADDRESS
TELEPHONE #
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PLUMBING PERMIT APPLICATION
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- ADDRES;j~ o:~;::/'
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SAN. WATER STORM
RELAY
PLUMBER"
NAME OF OWNER
IUe
NEW
STORM
11
NEW REP. NEW REP. NEW REP.
Bath Tub I Gar. Disposal Catch Basin
Wash Basin -Z Dishwasher i Conductors
Water Closet ;:z Laundramats , Grease C.B.
Sink j Water Softener Sumn Pumn I
Water Heater San. Bubblers Bar Was tes
Shower Bath Urinals Range Boiler
Floor Drain Dental Cuspidors Future Outlets I I I