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CITY OF OSHKOSH N- 42063
4 PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG( SIGN El ZONING FLOOD PLAIN HEIGHT
ADDRESS / '‘2 3 '',l PLAN NO.
OWNER i, 2 ,.
DESIGNER
USE /NATURE OF WORK /��w�i` .�� /�. ' �, � _ f
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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
— BT _ WH i/p WSoft _ CBasin ✓ 0
Lav Sh _ DW _ DF ( San. Sewer r r C '
WC _ FDr SP Ur ( Storm Sewer 6 f v C-
- Sink _ LTub _ Eject _ SS _ Water
Other
/
FEES: Valuation $ G 6 ° - 0 a
Pe rmit Fee Paid $ C' (:) Park Dedication $
ISSUED BY " " o �/
Date Final /O.P. ?` a " /7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE #(0a4ee-c7 /0--/0 -Ty
AGENT/ ER
DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION _l___
ADDRESS / - l/.r.c...�< •
OWNER • / - DATE 7 PERMIT# 6 6g
l PLUMBER /fi • / o
NATURE OP tic; - i. � -" ' - „ r •�- -
-- ��� NEW REPAIR _ INT
SAN SEW PVC
WATER
Bathtub #
V Sump Pump
E•ector
ZNSPECTION . nq� Water Softener
DATE Drinking Fountain
Sink other Urinal
�0 --t.a—' W terheater Slop Sink
Sower Grease Trap
Floor Drain Local Waste
�°l V2/ Laundr Tub Site Drain
, Disposal Laundry Standpipe
Dishwasher Catch Basin
** ,•.
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