HomeMy WebLinkAbout0011912- Plumbing (water heater) CITY OF OSHKOSH No 11. 912
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /10,/ Al- �e PLAN NO.
OWNER 1iftrn- , 4 :r /':=<L� r
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DESIGNER
USE/NATURE OF WORK of ;2%' Gt' /,,y�'G'-�=�,
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
•
HEATING CONTRACTOR
Heat ❑ NC ❑ Vent ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR —�.,/ 4 .
BT / WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
-WC FDr SP Ur Storm Sewer
-Sink LTub Eject SS Water
Other
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FEES: Valuation $ 3 --5 Permit Fee Paid $ , -u'' Park Dedication $
ISSUED BY7. ---------.-- Date /7 2-7 8 k Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /-4 f�' ,„ �
/(' /Z 2-7 T
A NT/OWNER DATE
ADDRESS
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