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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
03183
TYPE:
BLDG 0 HTG 0 ELEC 0 PLBG J2f-SIGN 0 ZONING
FLOOD PLAIN
HEIGHT
OWNER
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PLAN NO.
ADDRESS
DESIGNER
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USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Class of Const.
Height
Occupancy Permit
Foundation
HEATING CONTRACTOR
~
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss.
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
New 0 Change 0 Temp 0
Type_ Volts_ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
cfllv,/t:5 S;AA /V---
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer ~'lrvRV(
,
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _LTub _ Eject _SS _ Water / ('c~;V--~o
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Other
FEES vaJua.o~O/) .--
ISSUED BY , ~rd'/
Permit. Fee Paid $
Date
...
/3~/-
L~:;/r~~l
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 "'- ~ ~~'1
AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
PLUMBER
(JJ2VIAA 5~~-
PLUMBING PERMIT APPLICATION
~/26 ~.?
03/6"3
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Z'
DATE
ADDRESS
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Cqv-cV'-e.~/c/./ /C
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NAME OF OWNER
NEW SAN. WATER STORM RELAY SAN . WATER STORM
Main to Curb Main to Curb
Curb to Bldg. Curb to Bldg.
Elect. Pumns Repair
Septic Tanks
5~/
NEW REP. NEW REP. NEW REP.
Ba th 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 Was tes
Shower Bath Urinals Range Boiler
Floor Drain Dental Cuspidors Future Outlets