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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
11588
TYPE:
BLDG D HTG D ELEC D PLBG Pl SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
1?lS- c}l;r-c J~~r-/
ff~A ~~//y
PLAN NO.
ADDRESS
DESIGNER
5??-<--</-Q/j.4_/ ?A/aL
USE/NATURE OF WORK
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
_BT
7rh~ ~1r<,uftz-1
_ Disp _ WSoft
PLUMBING CONTRACTOR
_Lav
_WH
_Sh
_DW
_SP
_DF
_ CBasin
J -1//'; .o::?L--('
-L- San. Sewer ~
_WC
_FDr
_ L Tub
_Ur
_ Storm Sewer
LWater / /; r?~~
_Sink
Other
_ Eject
_SS
FEES: Valuation $
ISSUED BY
Permit Fee Paid $
Date
/g
tt -y/~
Park Dedication $
Final/O.P. /~//'~A7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .>L ~ 9.;J-z~ 5!i:::
~ . AGENT/OWNER ----- V
L-/
ADDRESS
DATE
TELEPHONE #
NATURE OF WORK
NEiol
~ ZING PERMIT APPLICATION
/8/'\~. '" DATE/lJ!I-Z:./ PERMIT# /L~&s'
PLUMBER ..... J ~ (~A ~/?- ~4 -
< <)~ -A../
RELAY
ADDRESS
OWNER
SAN SEW LIt! I :iF 4;
WATER 1M Bathtub Catch Basin
C:'l'I"l'RM SEW Lavatorv Grease Trap
Toilet S UtnD PutnD
INSPECTION DATE INSPECTION DATE Kit. Sink Lac al Waste .
, ..."',""",.' >,' " Sink(other) Site Drain
r- /0 l,r(?,J ~-/ Shower Laundry Stand P1.pe
Floor Drain Laundrv Tray
DisDosal Wat. Softner
Dishwasher , D. Fountain
Water Heater Ejector
TT,.i n al s Future outlets
REPAIR
INTERIOR
1** Violation notes on the reverse sidel