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CITY OF OSHKOSH
Address Owner /
Lot Block Ward Subdivision `
Type of Permit: Building ❑ Electri al ❑ Heating P bing ❑ Sign ❑ Wrecking ❑
Nature of Work: ^ --I L,- - . - / r� r- A
BUILDING Use
Roof
No. of Rooms
Size - Width
Height: Stories
Architect
General Cont.
Mason
Carpenter
Heating
Electric
Plumbing
Siding
Type of Const.
Length _
Above Grade_
0
a
0
Q
Foundation
Sq. Ft.
(Rear of Lot)
Width of Lot
Area of Lot Sq. Ft.
(Front of Lot)
No. Street
Occupancy Date
PLUMBING CONTRACTOR
Bu. San. Sewer Curb to Bu.
Bu. St. Sewer Curb to Bu.
Water Service
Bath Tub
Wash Basin
Water Closet_
Kit. Sink _
Water Heater_
Shower Bath_
Plumbing Fees
Code
Zoning Floodplain
Permit Date "�f _ '
Main to Curb:
Main to Curb
Floor Drain
ft.
Garbage Disp.
ft.
Dish Washer
Catch Basin
Laundry Mach.
S. Pump
ft.
(Front of Lot)
No. Street
Occupancy Date
PLUMBING CONTRACTOR
Bu. San. Sewer Curb to Bu.
Bu. St. Sewer Curb to Bu.
Water Service
Bath Tub
Wash Basin
Water Closet_
Kit. Sink _
Water Heater_
Shower Bath_
Plumbing Fees
Code
Zoning Floodplain
Permit Date "�f _ '
Main to Curb:
Main to Curb
Floor Drain
Urinal
Garbage Disp.
S. Sink
Dish Washer
Catch Basin
Laundry Mach.
S. Pump
Water Soft.
B & S Waste
Bubbler
Conductors
Total Fees
Sewer Fees
HEATING CONTRACTOR _L
Fuel: Gas Oil ❑ Elec. ❑ Solar Solid ❑
Conditioning Forced Air Q H.W. ❑ Elec. Base ❑ Steam ❑
System Gravity ❑ Supplementary ❑ Air Cond. ❑
Chimney: "A" 1K "B" ❑ Direct Vent ❑ Con. Burner ❑
Calculated Heat Loss qc System BTU Rating
ELECTRIC CONTRACT_ [nR
Electric Service: New
Description -Type
Fixtures
Appliances
Signs
Inspections - Footing Foundation
Sewer Water Service R. 1.
In the performance of this work the undersigned agrees to abide by and do work pursuant to all statutes,
codes, and rules governing the above described construction. x
nances,
Switches
Changes
Volts.
Recep's
Temp,
- Amps
Circ's
6'G
Electric Service stimated Cosh -�
Final .,L�{� 79 Fees Paid 5
Date S_ W l
r
Authorize gnature Inspector