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~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
15624
TYPE:
BLDG D HTG D ELEC D PLBG & SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
/8tr cJr-~/~/c~
&vor-!i-
PLAN NO.
ADDRESS
DESIGNER
~ ~~ ~.,/. bt/"a4-eJ-
USE/NATURE OF WORK
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
VmA~
GA Lc~
_WC
_FDr
_Disp _ WSoft _ CBasin
_DW _DF -('San. Sewer c/lr~v<"-
_SP _Ur _ Storm Sewer
_ Eject _SS + Water / It
, ropr-e
_BT
_WH
_Sh
_Lav
_Sink
Other
_ L Tub
FEER valuat;:;/f3~
ISSUED BY /
I
2 4D-V
Permit Fee Paid $ 0
Date ?-~?-~
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE II- r
ADDRESS
~
AGENTIOWNE~
DATE
TELEPHONE #
ADDRESS
OWNER
NATURE OF WORK
/
~ PLUMBING PERMIT APPLICATION
?4!7/4/: DATE ~/ ~/J?f'
PLUMBER ;'J) l'~/f' r
\J
PERMIT if /~t2 {
~g(~ 4~ /4(~
, J V
SAN SEW iF iF
WATER Bathtub Catch Basin
STORM SEW Lavatorv Grease Trap
Toile't Sump P1.1mp
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
(cfVC/C j ufo I ji-f Sink( other) Site Drain
Shower Laundry Stand p~pe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Founta~n
Wa.t:er .... Rea ter Ejector'
Urinals Future outlets
NEW
RELAY
REPAIR
INTERIOR
l** Violation notes on reverse sideJ