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HomeMy WebLinkAbout1986-Plumbing (water & sewer laterals) � _ CITY OF OSH KOSH No _ 02118 PERMIT APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS , � � �����•�"��� / PLAN NO. - OWNER__ i �" �'L.t�-P/l.L. DESIGNER USE/NATURE OF WORK U�'���%L'�-.�r-��� %r�r�+F�- �r/c'�c� 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 PWMBING C�NTRACT�R �"?/�1 '7� —BT —WH —Disp —WSoft _CBasin _� —Lav —Sh _DW —DF —San. Sewer '� �t'7v� —WC —FDr —SP _Ur —Storm Sewer —Sink _LTub _Eject —SS —Water �� � ro�D���� Other <,�- ,�-��._ FEES: Valuation $-1y,7i,L37� Permit Fee Paid $ Park Dedication $ ISSUED BY 'f�-1�,�, �_ �� Date �� � — Final/O.P. ����� In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction. �� r � ' SIGNATURE � ll������"`� J��' AGENT/OWNER DATE ADDRESS TELEPHONE#