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HomeMy WebLinkAbout0040777-Plumbing (toilet & lav) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD V/O N!!-40777 ~P_E~ _ _ ~L~~ _~ _ ~T~ _ C? _ ~~E~ _ ~ _ ~~B~ ~_ ~I~~ _~ _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS~O rt~(l (S-\:. OWNER ~o. ~ 1~G dmO en. ~ PLAN NO. DESIGNER USE/NATURE OF WORK l<,Q~~ @Q. ~~* 9- jCH.r J. fY\ ()ormo QO{? (l,\16rJ BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Servo New 0 Change 0 Temp 0 Type _ Volts _ Amps_ Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR ~11.LlMhl _BT _WH _Disp -L- Lav _Sh _OW --I- WC _FOr _SP _Sink _LTub _ Eject Other _ WSoft _OF _ CBasin ~ _Ur _ San. Sewer _ Storm Sewer _SS _ Water FEES: Valuation $ :;::160. C{) ~---- ISSUED BY / Permit Fee Paid $ 10, D C ./" Park Dedication $ Date'r~ ~//CjfFinal/O.p. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE--d= - ADDRESS ~ g-((-r'1 DATE AGENT/OWNER TELEPHONE #