HomeMy WebLinkAbout0037613-Plumbing
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N2
jL'O/
37613
TYPE:
BLDG D HTG D ELEC D PLBG W' SIGN D ZONING
FLOOD PLAIN
HEIGHT
ADDRESS
..2..s- A6
&~
PLAN NO.
OWNER
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
PLUMBING CONTRACTOR
/(~
_BT
_WH
_Sh
_Disp
_OW
_SP
_ WSoft
_OF
_ CBasin
~ San. Sewer
L Storm Sewer
L Water
jf Iv G
Vlvc
Ie!.--
~
_Lav
_WC
_FOr
_ LTub
_Ur
_Sink'
Other
_ Eject
_SS
if/
FEES: Valuation $
ISSUED BY
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d;$Z
Permit Fee Paid $ 3 c. 0 '0
Date 0pY
I
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~d (J~z:;
AGENT/OWNER
/-,/ f/- ~'v
DATE
ADDRESS f9J i/ ,<;4/'r/-e ~/
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SCf'.)- 3 f 7<~
TELEPHONE #
S-V 9 J&.
ADDRESS
OQNER
9ATtJR!
SAN SEtl
wATER
NSPECTION DATE
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REI.AY
REPAIR
DA'l:!
** Viola~ion no~es on the reverse 9ide(
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3.7t/~
#
Bath~ub
Lava~o
Toilet
Kit. Sink
Sink( other
w te heater
#