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CITY OF OSHKOSH N° 36240
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS l 7 7 l/ U
PLAN NO.
OWNER K Ccrt
DESIGNER
USE /NATURE OF WORK 44 f
�V
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 p Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 4N 7
JBT t WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC 1 FDr -4. SP Ur
—Storm Sewer
Sink _L L- /9 w Eject SS Water
Other
FEES: Valuation 2 ,°6- o o Permit Fee Paid 3C Q 0
Park Dedication
ISSUED BY Date a /V7-3 Final /O.P. a
7/ 9 y
In the performance of this wo I agree to perform all work p suant to rules governing the described construction.
SIGNATURE 7 -3-1'3
z GEN ER DATE
ADDRESS �D /7. /6(6, .0c1/1. tJ 2 .,,O D
TELEPHONE
Ka
PLUMBING PERMIT APPLICATION
ADDRESS S V DazE PEz# a
owNEa PLUMBER S penf�
:MATURE of WORE /V c
NEPJ RELAY REPAIR INTERIOR
SAN SETS
!R Bathtub
yam
S f Sump Pump f
i Lavatory Ejector
Toilet Water Softener
INSPECTION DATE INSPECTION DOT Kit. Sink Drinkin Fountain
Sink(other) Urinal
Waterheater Slop Sink
����1 Shower Grease Trap
c 3 Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
/i Dishwasher 1 Catch Basin
f S
*Or Violation notes on the re rse side(
b
7. ra tiin
r)