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CITY OF OSHKOSH N° 38302
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / o S.5 Z , `_ ' A "
PLAN NO.
OWNER . ill , R /.(
DESIGNER
7 /
USE /NATURE OF WORK / / .z 3 C _ 3
BUILDING CONTRACTOR '
Size Sq. Ft. # Rooms
# Stories Height
Foundation Class of Const.
Occupancy Permit
HEATING CONTRACTOR
Heat ❑f A/C ❑ Vent ❑ Fuel /System
Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles p Circuits
PLUMBING CONTRACTOR — -- f
— BT — WH Disp WSOft
— CBasin
/3
— Lav — Sh _ DW DF
San. Sewer
— WC — FDr — SP — Ur
—Storm Sewer
— Sink _L. LTub — Eject — SS
Other —Water
FEES: Valuation $ 4'0 • 0 0 Permit Fee Paid $ ®, d
� Park Dedication $
ISSUED BY Date j2 9�
/ Final /O.P. a/ �/ q
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ;4. t
... AGENT /OWNER
VVV DATE
ADDRESS
TELEPHONE #
Z
PLUMBING PERMIT APPLICATI N
ADDRESS, f 5 2-5-- L� • / DATE a '- �� 0
�j PE T#
OWNER . 6-- '/ . L '�,� ?/ P Eg -
NATURE OF WORE F ' - -# 3 3
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER Bathtub Sum. Pu
TOBI SEW L avato r9 Ejector
Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink Drinkin Q Fountain
Sink(other) , Urinal
, Waterheater Slop Sink
��� �� Shower Grease Trap
Floor Drain Local Waste
/ Laundry Tub Site Drain
Disposal Laundry Standpipe
1 Dishwasher Catch Basin
—
** Violation notes on the reverse side j