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CITY OF OSHKOSH
N2 40443
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG$ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / / 6 ' ii g, PLAN NO.
OWNER —''
DESIGNER
'
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 -` �= -�� �� /
f BT WH _ Disp _ WSoft — CBasin
L v Sh 2 DW _ DF _ San. Sewer
WC . FDr SP Ur _ Storm Sewer
_I_ Sink 4.6-Tab/ loft' _ Eject _SS _ Water
Other
FEES: Valuation $ -3-2-6 cr • d ° Permit Fee Paid $ � Park Dedication $
ISSUED BY �/r� Date �/' Final /O.P. 1 1-.2_9-9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ∎ i 7-id--9
AGENT/OWNER DATE
ADDRESS ■SS 4, L f- ry7,0��.1,. 7 30 —O,L J —
TELEPHONE #
ADDRESS 3/4 z- Q , / /_ ofr �� INC PERMIT APPLICATION OWNER I�- DATE // " ' V pE �!�
� ;:u SAN i � �
/
daTDBE OF WORK V / - _ .T / / /
NEW RELAY REPAIR ' •'RIOR
SEW
WA1E e #
• : y Dr. �� S um• Pu
PZ Lavato E'ector
�� I+ Toe t
4-• " ON il _ Water Softener
DATE Drinkin• Fountain
NM Sink( other
s
I.
CMG.- S ' /,� 3 - 3 sM
c- 6/7 Ira " t " i ll rrIMIV Slo• Sink
ease Tra.
MI Floor Drain Local Waste
1 (0/7 NE Laundry Tu.
Site Drain
Dis.osal Laundr Stand.i.e
j 7 )'/(/ WI Dishwasher Catch Basin
k) i y I. ' iir e"' 0 A 1 ,
_or)) 0.-4?/,---1,-n-.2--' -- vk7t , • . •., ; /„.„ �^�� .t4 1 ' ti--e-------e-E