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CITY OF OSHKOSH N 37268
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG xi
SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS /t/ t Del--
PLAN NO.
OWNER ..e=-C
DESIGNER
.......e.„. .i.r...Z
USE /NATURE OF WORK
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 i E" /�G
BT WH Disp WSoft CBasin
Lay Sh DW DF t San. Sewer 't-f(j c
WC FDr SP Ur _L Storm Sewer Le‘
e C
Sink LTub Eject SS Water
Other
N ®o
7
FEES: Valuation 0 Permit Fee Paid 3 Park Dedication
ISSUED BY Datef"y /793
Final /O. P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR may/ /2//577
AGEN ER
TE
ADDRESS
TELEPHONE
PLV I PERMIT APPLICATION
ADDRESS. z� 0 Q- Ji L DATE 1 3 PERI�T# 3726- a E
OWNER p t■ ER U _-e,
NATURE OF WORE sie-Q 0 .4
NEW RELAY REPAIR is RIOR
SE
SAN W �PtiC
N AT ER Bathtub Sump Pump
ORM SEW Uc Lavatory Ejector
Toilet Water Softener
INSPECTION DATE INSPE ON DATE Kit. Sink Drinkin Q Fountain
q
Sink(other) ----Urinal
v ".4-
Waterheater Slop Sink
Shower Grease Trap
Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
Dishwasher Catch Basin
Violation notes on the reverse side{