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CITY OF OSHKOSH N° 39340
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS i 1 Z PLAN NO.
I 7 OWNER
DESIGNER
USE /NATURE OF WORK 12.S/
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 L
BT c WH Disp WSoft CBasin CJG�
)�av _e Sh DW DF San. Sewer
FDr j_ SP Ur Storm Sewer
f Sink _A LTub Eject t SS Water
Other CLv
FEES: Valuation g 'a47:7 s 6 ci Permit Fee Paid .5
0 d Park Dedication
ISSUED BY (jc/ Date L-57 Final /O.P. 4 Z 'eir
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .1 N
.5 AGENT /OWNER DATE
ADDRESS 1 i La Ilk _7 1 0 0.2-05-
TELEPHONE
5
PLUMBING PERMIT APPLICATION
ArDRESS, 7 1
e �t�� DY1TE D. 'Z
OWNER 4 PLVMBER s
NATURE Or WORK k A IIIII
NEW RELAY REPAIR INTERIOR
SAN SEW
WATER Bathtub
Su Pu
Lavato Ejector
t. CTION DATE I Water Softener
Y Drinkin Fountain
(I /I1 Sink( other
i Waterheater Slop Sink
7 Shower Grease Trap
2 j) u
au
Floor Drain Local Waste
EI r �i v a 7� Lnd Tu.
Z IIII Site Drain
E tAl C} Disposal Laundry Standpipe
1 Di washe
i
Catch Basin
r e 1 .1
i A v
Violation notes on the reverse side( L'?;- 0
v
40 90
m
Sr�
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