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N2 39211
CITY OF OSHKOSH
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 6 ,f o PLAN NO.
OWNER /'isr�' S
DESIGNER
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USE/ •TUR OF ORK y
.2--// I /9y
BUILDING CONTRACTOR
Size Sq. Ft. Rooms Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR D g� -Ca�"
rf'
BT _i_ WH Disp WSoft CBasin
g
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
Da-c,....1-4 F
FEES: Valuation -O ate, e'' Permit Fee Paid Park Dedication
ISSUED BY M/ Date 5.- Y9 Final /O.P
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE %J't�✓ 21 4 7 C
AGENT/OWNER a4-2/. DATE ADDRESS 7 7-18.1/{,/)' S 4 ER 34-
TELEPHONE
y PLUMBING PERMIT APPLICATIO
ADDRESS 6 DATE PE T# 2z
OWNER A/l -tom -u uric= �c s nmesER -z.- /1(-�_ -e..
NATURE 07 WORE /I( 1 M
NEW REPAIR INTERIOR
SAN SEAT
WATER Bathtub Sump Pump
r• A. Lavato E "ector
Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink Drinking Fountain
Sink(other) Urinal
5-4///: Shower Slop Sink
Shower Grease Trap
Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
4
ishwas er Catch Basin
le
Violation notes on the reverse side S�z�...�