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~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
19071
TYPE: BLDG D HTG D ELEC D PLBG ~ SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
/705 CJo~ (~L. ~~e
Aoie~+d ~-<I~I
PLAN NO.
ADDRESS
DESIGNER
se~~A- ~~-<a~ h~a'{
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
PLUMBING CONTRACTOR Uerv..s C<:f'Vlf~c~
_BT _WH _Disp _WSoft
_Lav
_Sh
_DW
_SP
_OF
_ CBasin
~ San. Sewer "7' * ~t/C
,
-I- Storm Sewer "1 e't? vc.
1 Water 1// /" t?fJjJ-P-^-
_WC
_FDr
_ L Tub
_Ur
_Sink
Other
_ Eject
_SS
FEES, Valua"on $ ~o;::
ISSUED BY ~ ~
Permit Fee Paid $ d () Cro ('
Date 6'-->> ..-90
.
Park Dedication $
Final/D.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURu~ -~-
. ./ AGENT/OWNER
ADDRESS
DATE
TELEPHONE #
ADDRESS
OWNER
NATURE
/76,)' PLUMBING PERMIT APPLICA'rION
..1/': ~ ~ . 4~ :"""7"I~' ~ /'. r-~ . /q (S 7 (
I':>"' ~"'- ~ 0" ~,.. _ DATE '" ~" --[4 PERMIT#. f
2. ' .~ .... ~.. - ... j ~ PLUMBER M~ c-,!Afr'7t"~(/
OF WORK ,S--e.--r A/./- t. "'_ /ll. . -
NEW RELAY REPAIR INTERIOR
SAN SEW 4F 4F
WATER Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
Shower Laundry Stand Pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
TTrinals Future outlets
(f)
f** Violation notes on the reverse sidel