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CITY OF OSHKOSH N2
PERMIT - APPLICATJ,ON AND RECORD
02911
TYPE:
BLOG 0 HTG 0 ELEC 0 PLBG S-SIGN 0 ZONING
FLOOD PLAIN
HEIGHT
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OWNER
DESIGNER
USE/NATURE OF WORK
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BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
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
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_BT
_WH
_Sh
_Disp
_OW
_SP
_ WSoft
---'- OF
_ CBasin
~San. Sewer i"6 ~Vc.
_ Storm Sewer
r/
- Water / C'CTo/".;:a.-..--
Ii'
_Lav
_WC
_FOr
_ L Tub
_Ur
_Sink
Other
_ Eject
_SS
: /
X-/'\1\ ~. /'e-a:o. -(
FEES, Valuat;on $ JL-h) ,- Penn" Fee Pa;d $ J - ~. _
ISSUED BY ~~r;r/ Date r?2/; ~)
Park Dedication $
Final/O.p. 1/7h)
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
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AGENT/OWNER
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DATE
ADDRESS
TELEPHONE #
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PLUMBING PERMIT APPLICATION
1/7/91
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PLUMBER
DATE
'"
NAME OF OWNER
ADDRESS
2,S7~
115(JZJ
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NEW SAN . WATER STORM RELAY SAN . WATER STORM
Main to Curb Main to Curb
Curb to Bldg. Curb to Bldg.
Elec t . Pumos Reoair
Septic tanks
NEW REP. NEW REP. NEW REP.
Bath Tub Gar. Disposal . Catch Basin
Wash Basin Dishwasher Conductors
Water Closet Laundramats Grease C.B.
Sink Water Softener Sumo Pumo
Water Heater San. Bubblers Bar Wastes
Shower Bath Urinals Range Boiler
Floor Drain Dental Cusoidors Future Outlets