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Address
PERMIT - APPLICATION AND RECORD
.-, .--, ; I . / ,/'
--'/::=> .5~.....< f.-..- r.J II-<!.
U
CITY OF OSHKOSH
RIOCk
Ward
Owner
Subdivision
Sign 0
i t)~.-.: /"~.(_-<-
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li /-C".-li<-.r
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" 15213
Id. No.
Flood Plain
, Permit:
Building:s:. Electrical 0
Heating 0
Plumbing 0
Wrecking 0 Occupancy Permit l?",? <,A',,;'~J
("1._ ...,
Zoning .. .:i
Insp.
,..... .-r---
(~ :~c.... ./
'L~i .- ;,~,.~'- VI
h ~ /~: .:;/, t7 Cl-/C/', //L -n /;:z.:: . '/.. ?g'
of Work ,( LA-. ' - , 1./ -"" BUILDING Use '~.f'- J>r".. ~-' -''';;f..-' '.~
/~ );?;/~ ~ .il u .- I II I /;
" General ConI. ( 'T')?/ ". ",. L (,L,1. /r--t;?
-'/(A"d../..--" ....r - ~':;"." ~
! /'
Roof Siding ..
/' ..
Foundation Type of Construction .n,~
I
I '. j r; ~ "'/ feet long ;1 Z9u
IBING CONTRACTOR /<. Z./h . c,..... Size: ) i.../ -( ~ feet wide X Square feet area
m, Sewer_ Curb to Bu. Main to Curb: Height: Stories and Basement feet above Grade
.. Sewer Curb to Bu, Main to Curb j
Width of Lot No. of Rooms
Sewer Fees 3 Mason
Service l I ') / . /i
Carpenter r:; /" '! ,~ I '. /c'vi,L
rub Floor Drain Urinal / ;) ,
Basin _ t3arbage Disp. _ S. Sink Arch~ect
Closet _ Dish Washer _ Catch Basin - ~
nk Laundry Mach. _ 5, Pump l t."
Heater _ Water Soft, B&SWaste _ ----11._ _----1t._ Inspections -
or Bath _ Bubbler Conductors Footing Foundation
ling Fees Total Fees ~
----- " 0 Electric Service R.1.
, 1 ~
=t" : .,'" c/,~-....--.J...__ 0
lNGC! ,CTOR y' /{:- i t Sewer Water Service
Gas L Oil 0 Elec.O Solar 0 Solid 0 0 Final /
tioning Forced Air 0 H,W.O Elec. Base 0 Steam 0 Radiant 0 l' rJ(.UV
n High Eff. 0 Supplementary 0 Air Condo 0 Ventilation 0 Estimated Cost->' /9 cJ Fees Paid '1- Date / .. IJ>di
ley: "A" 0 "B" 0 Direct Vent 0 Con. Burner 0 Flue Damper & E.!. 0 TO THE BUILDING INSPECTOR: In accordance with Section 7.18 of the Municipal Code oltOO City of Oshkosh, it is agreed that if work shaUl
latOO Heat Loss System BTU Rating discontinued for a period of30 days at any Ume for any cause after excavation work is commenced, a solid barrier, wall, or wire fence not less th
five feet in height shall be erected all around such excavation. Such barrier, wall or wire fence will remain in position until removal is approved by t
/' j,f/ Building Inspector. X
TRIC CONTRACTOR '., r- r ,{X.._~;'I~t,....L_.<-..-,./ In the performance of~l1is work the undersigned agrees to abide by and do work pursuant to all statutes, ordinance
/ ,
c Service: New Changes Temp, codes, and rules' go~erning thej>'s99bed construction,
iption.Type Volts Amps_ . // :?'. /. ..7 Own
(Signed) / .\....,0.fY'?.?? /~;~<....---"
3S Switches Recep's Circ's ," - . J/ ,",,/_9","'~/"<' ".... '7:?'- '7,< 1./'
"F ;?,;)3 /./'/ ,?.// ,-, q,~'
nces Address /-7,'-"';!'" /-50 y o ',.-1. Phone--::-'-v' ,;; -. '-'" ,; /)
By Age
(Authorized Signature)
:cal Signs Address Phone
--, . . ._--"- ...._..._...,_.._~..._--. . .. -_.~.. 0""'- -~ -------. .. "". ---.-..--.. ---.-. ... _nO.
Perm~Date /-Ig-')'
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