HomeMy WebLinkAbout0021000-Plumbing
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
21000
TYPE: BLDG D HTG D ELEC D PLBG.IM SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
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PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
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BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
_BT
_WH
_Sh
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_Disp
~DW
_ WSoft
_DF
_ CBasin
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PLUMBING CONTRACTOR
_Lav
_ San. Sewer
_WC
iSink
_FDr
_ L Tub
_SP
_Ur
_ Storm Sewer
_ Water
_ Eject
_SS
Other
FEES: Valuation $ g S"b Permit Fee Paid $
ISSUED BY c~ ~ Date
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Park Dedication $
Final/O.P.
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In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE yL
ADDRESS
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EijNER
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