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HomeMy WebLinkAbout0017004-Remodel 2nd Floor ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 17004 ~P_E~ _ _ ~L~~ ~T~ _ C? _ ~~E? _ ~ _ ~~B~ _~ _ ~I~~ _~ _ ~O_N~N_G _ _ __ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS ~tr- 1/~k OWNER DESIGNER 1---59- /7/ 4&4 XL"fi( +~c- PLAN NO. USE/NATURE OF WORK /'~4/~ ~t-~ $qn- /2'1,4, </ C}~~dr,~~..t BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Cons~. HEAT~G CONTRACTOR Heat 0 NC 0 Vent 0 Fuel/System t' Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Servo Type _ Volts _ Amps_ Fixtures Switches New 0 Change 0 Temp 0 Receptacles Circuits PLUMBING CONTRACTOR A} C ?~ ( !I- BT LWH ~Lav _Sh !:/- WC _ FDr 4- Sink - L Tub Other /,.... hA../1A-~<L. - 7 ~ ""'b FEES: Valuation $ ~@ ISSUED BY ~A /' ~ _Disp _ WSoft _ CBasin _DW _DF _ San. Sewer _SP _Ur _ Storm Sewer _ Eject _S8 _ Water ~ ~c( / '\/' Permit Fee Paid $ 81?<PJ Date 1- /27'0 Park Dedication $ Final/O.P. 3 - c;l3 - ~ b In the performance of this work I agree to perform all work pursuant to rules g~verning the described construction. SIGNATURFh fJ~P (! .~~ t AGENT/OWNER ADDRESS //;1 ),(J , VOATE TELEPHONE # ADDRESS OWNE R NATURE /39-1<(/ /II'';!.. kL^,~~}l OF WORK _'dA A NEW RELAY PLUMBING PERMIT APPLICATION ".. DATE J- /?- -90 PERMIT# PLlJ.mE~ 't2('~~{ .k- J;wv ~O.J: ~/ r:;P/s - REPAIR INTERIOR /700<( SAN SEW iF iF WATER L./ Bathtub 1111 Catch Basin ~'T'ORM SEW <; Lava tory fill Grease Trap U Toilet lIil Sump Pump INSPECTION DATE INSPECTION DATE <I Kit. Sink ',. II Local Waste KJ- Sink(other Site Drain r'^' Shower / Laundry Stand Pipel Floor Drain Laundry Tray f 31Jc'y I~ Disposal . Wat. Softner Dishwasher D. Fountain '" Water Heater l'UJ Ejector Urinals ... Future outlets ~ t** Violation notes on the reverse sidet