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CITY OF OSHKOSH N° 28433
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC El PLBG g SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 5 )-- PLAN NO.
OWNER 1 F gi7-
DESIGNER
USE /NATURE OF WORK 444-- ` 1--- f\
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 d /
BT WH Disp WSoft CBasin
3 Lav Sh DW DF San. Sewer
WC .7---- SP Ur Storm Sewer
,- "Sink LTub ject SS Water
Other / - 6 r tt
FEES: Valuation $ le3i COO • o d Permit Fee Paid $ 5 - ° Park Dedication $
ISSUED BY (%` Date VY - Final /O.P.
In the performance of pis work I agree to perform all work pursuant to rules governing the described construction.
/
SIGNATURE ,,.� /� -576 �
AGE; /OWNER DA E
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS, C ' =- 0_,- -- D� 5- s- ,, ._ S 3
, j � PERMIT#
OielNER �/ a7u- - B F.,ze------z°-z- -- / PLUMBER /��-- -c-1L-
NATURE OF WORK \ ��,,t— �i L� _-
NEW RELAY REPAIR INTERIOR
SAN SEW # .
wA1 Bathtub
IIOM SEW Sump Pump
Lavatory Ejector
Toilet Water Softener
INSPECT/ ON DATE INSPECTION DATE Kit. Sink INK Drinking Fountain
�.'r
� C f • / / ' � " 57// C) vi -sit/ Sink(other) Urinal
KI, Waterheater Slop Sink
e7-2 Shower Grease Trap
2 Floor Drain Local Waste
P te, Laundry Tub Site Drain
3 Disposal Laundry Standpipe
V V
F o Dishwasher
µ�-� -✓ _ _ Catch Basin
1)1, �- .oa � � - -= —
, ...e- 0 gyti
** Violation notes on the reverse side]