HomeMy WebLinkAbout0044035-Plumbing (inside)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
Y/CD>
N! 44035
~P.E~ . . ~L~~ _~ _ ~T~. ~. ~~E~ _ C? ~~B~ #. ~I~~ _~ . ~O_N~~~ _ _ . . _ _ .F~~~D. ~~I~ _ _ _ . . . ~~I~~T_ . _ _ _
ADDRESS /fl';L? R1 L c~ PLAN NO.
OWNER ,O~_ ~
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DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft.
Foundation
# Rooms
# Stories
Height
Occupancy Permit
Class of Const.
t.
HEATING CONTRACTOR
Heat D AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo New 0 Change 0 Temp 0
Type
Volt~ _ Amps_
Circuits
Fixtures
Switches
Receptacles
PLUMBING CONTRACTOR :::r- ~ fI~_
-LBT -LWH -1 Disp _ CBasin G
. _ WSoft
-L Lav _Sh -Low _OF _ San. Sewer
-Lwc -L FOr -'- SP _Ur _ Storm Sewer
-LSink -I-JdftJb fJc 111 -I- Eject _SS _ Water
Other
ISSUED BY
~----
Permit Fee Paid $
Date
/
Y<r: 0 aj
V9//'S-
/ /'
Park Dedication $
Final/O.P. /0 -C/-t:;5
FEES: Valuation $ 5L/ 0 a . 0 a
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE #/7 7+l~~
/' A I WNER _
3/etl/9S-
DATE
ADDRESS
TELEPHONE II
,
me PEIHIT APPLICATION ,?-C/o
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OF WOlUt
NEtl
RELAY
BEP AIR
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SPE CTI ON
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tNSHcnOR
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