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PERMIT — APPLICATION AND RECORD CITY OF OSHKOSH N! 1 4 1 8 0
Address a/6 d/Le'acr--Y' 4r-1..- . Owner GV / 6 Id. No.
Rlock_ Ward Subdivision Zoning 0 _'- Flood Plain �o
Permit: BuildingyL Electrical ❑ Heating ❑ Plumbing ❑ Sign ❑ Wrecking ❑ Occupancy Permit • VES Insp../ /2 Permit Date LO "Z
of Work /; 1 u-� , BUILDING Use ��� / /� ::r. / !'gib ���._
Q /
General Cont. L`^ ^
Roof -....�i .� Siding G^ °
Foundation _ -- ' _ ��_%,,, / Type of Construction C
BING CONTRACTOR , p Size: - �� feet wide X 22 feet long 4 S
� Ct_ g Square feet area
tn. Sewer Curb to Bu. Main to Curb: Height: 1 Stories and Basement / S feet above Grade
. Sewer Curb to Bu. Main to Curb 4), No. of Rooms
Width of Lot
Sewer Fees ; Mason e2c-
Service 7.S -1 Carpenter v - ' '�"T
"ub Floor Drain Urinal e"X
•
Basin Garbage Disp. S. Sink i 11 Architect
Closet Dish Washer Catch Basin 1
v t 'K
nk Laundry Mach. S. Pump ' ft „
Heater Water Soft. B & S Waste e ft
' Inspections -
- Y�ft �-. V s�
:r Bath Bubbler Conductors
K 3? Footing Foundation
ing Fees Total Fees C C?
.
f� $ 3 Electric Service R.I.
I 1
ING C" ACTO � -� 2 s Sewer Water Service
Gas G Oil ❑ Elec. ❑ Solar ❑ Solid ❑ _ o
:i Forced Air ❑ H.W. ❑ Elec. Base ❑ Steam ❑ Radiant ❑ �� Final G
n High Eft. Estimated Cos
. ❑ Supplementary ❑ Air Cond. ❑ Ventilation ❑ 436'0 t//
Fe 7 Fees Pai4 -7. 7 O0 Date q --- ' 4) q --- ' 4) p
e "A" ❑ "B" ❑ Direct Vent ❑ Con. Burner ❑ Flue Damper & E.I. ❑ TO THE BUILDING INSPECTOR In accordance with Section 7 -18 of the Municipal Code of the City of Oshkosh, it is agreed that if work shall be
ated Heat Loss System BTU Rating discontinued for a period of 30 days at any lime for any cause after excavation work is commenced, a solid barrier, wall, or wire fence not less than
five feet in height shall be erected all around such excavation. Such barrier, wall or wire fence will remain in position until removal is approved by the
Building Inspector. X
TRIC CONTRACTOR r In the performance of this work the undersigned agrees to abide by and do work pursuant to all statutes, ordinances,
c Service: New Changes Temp. codes, and rules governing the de deEibed5onstruction.
ption -Type Volts Amps '7
is Switches Recep's Circ's (Signed) �C ^ 7-.I( . PT i �� /�/ / / " > Owner
nces Address Z /,i » a/. A...' ��%G�C bbi 3? -,79 --
Phone �
By (Authorized Signature) Agent
cal Signs
/ Address Phone
/ - SI 3 44
1 . 2r -13 . 1/ - u, �2 3 /6P