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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
15685
TYPE:
BLDG D HTG D ELEC D PLBG ~IGN D ZONING
FLOOD PLAIN
HEIGHT
--.. --........ --.. --.. --- ---.. --...... -- --.. --.. -- --.. -- --........ --.... --- --.. -.. --.. ----...
ADDRESS ..231 t.f ~rr ,-,So" ~-k::
OWNER ~."''lte.s t< l n&eY'''''''-CU..
PLAN NO.
DESIGNER
USE/NATURE OF WORK R t2-WLO.,.Qe.-(
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D NC 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 W\ .t? i< e...t l'i 1 ~ C-..
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
Lwc _FDr _SP _Ur _ Storm Sewer
~Sink _ L Tub _ Eject _SS _ Water
Other 3- .L....OC"'l I w&:i$-fe
DC?
FEES: Valuation $ /SOO:"'---
ISSUED BY ~.-~
4100/
Permit Fee Paid $_
Date /0- :2 - rY
Park Dedication $
Final/O.P.
c2 - 13 - 89
In the performance of this work I agree to perform all work pursuar.: ;0 rules governing the described construction.
SIGNATURE J#.~~~.
AGENT/OWNER
jolL/of'
. DATE
ADDRESS
TELEPHONE #
~W\) ~
ADDRESS
OWNER
NA'!URE OF YORK
NE'tol
'pLUMBING PE-:A:rLI;:~ ~
PLUMBE~. ./
PER.'1ITfr
RELAY
REPAIR
!N'I'EIUOR
SAN SEW iF fF
YATER Bathtub Catch Basin
~,.n'RM ~mJ Lavatory i Grease Trap
Toilet I S uml) Punro
lNSPEcnON DATE INSPE en ON DATE Kit. Sink \.~ Local Yaste
..2//3trl @) I Sink(other) Site Drain
f Shower Laundry Stand P1.pe
!/j Floor Drain Laundry Tray
Dis'Posal Yat. Softner
Dishwasher D. Fountain
Water Heater Ejector
"~inals Future outlets
r** Violation note~ on the reverse side{