HomeMy WebLinkAbout0002543-Plumbing (laterals)
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CITY OF OSHKOSH N~
PERMIT - APPLICATION AND RECORD
02543
TYPE: BLDG D HTG D ELEC D PLBG ffSlGN D ZONING
FLOOD PLAIN
HEIGHT
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
OWNER
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PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
s y L...J
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Li J
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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
PLUMBING CONTRACTOR
Kl ~,v~ T
_Sink
Other
_ Eject
_ WSoft _ CBasin
_OF L San. Sewer /-tJ - 0 iJ
_Ur _ Storm Sewer
_SS L Water S- ac)
_WC
_FOr
_ L Tub
_Disp
_OW
_SP
_BT
_WH
_Sh
_Lav
ISSUED BY
/:5: CJ ()
n,#-7
Park Dedication $
Final/O.P. J r'~r'Y1
FEES: Valuation $
Date
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
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~ ~WNER
DATE
ADDRESS
TELEPHONE #
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