HomeMy WebLinkAbout0042024-Plumbing (bath/laundry)
(fI:;
~
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
p~
N~ - 42024
:~:E~~ ~L~~ .r:: _ ~; : :: l? ;~. _ _ _ . :~~~D. p~:~~ ~~.' . ~~'~~T. . - - .
OWNER D~ L
DESIGNER
f!. r~ If/ff
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Class of Const.
., ,,,.,J::
HE~TING CONTRACTOR
H'~at D 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
_BT -LWH
~a~
_WC
_Sh
_FOr
_ L Tub
_Disp
_OW
_SP
_ WSoft
_ CBasin
~
_Lav
_OF
_ San. Sewer
_ Storm Sewer
_ Water
_Ur
_Sink
Other
_ Eject
_SS
Permit Fee Paid $
Date
/
~o.otJ/
1'6 ?/j;jL
/ / /
Park Dedication $
Final/O.P.
FEES: Valuation $ C C> 0 0 r .~ -0
~
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR~~!l..4
AGENT/OWNER
/CJ~7-9r
DATE
ADDRESS
TELEPHONE #