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HomeMy WebLinkAbout0005999-Plumbing (interior) ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD o 999 TYPE: BLDG D HTG D ELEC D PLBG ~IGN D ZONING . FLOOD) PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - ~ - - - - -1- - - - - - - - - - - - - - - - -- ADDRESS /7/7 dfG'forJ PLAN NO. OWNER '4- if-o Lrf /1,11) DESIGNER USE/NATURE OF WORK .::s:/- 4~ BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. I HEATING CONTRACTOR Heat D AlC D Vent D Fuel/System Heat Loss. BTU'S ELECTRIC CONTRACTOR Electric Servo Type_ Volts_ Amps_ Fixtures Switches New D Change D Temp D Receptacles Circuits c; () 'I r/ffr ~ Disp _ WSoft L DW _ DF '::J SP _ Ur PLUMBING CONTRACTOR <t.lJ ..s.J ~ BT ~ WH 2- Lav ~Sh -.!'J WC 3 FDr -!- Sink ~ L Tub Other :;:) SC.r I...)~..s; f~ ISSUED BY FEES: Valuation $ _ CBasin _ San. Sewer _ Storm Sewer _ Eject _SS _ Water Permit Fee Paid $ Date ) 7" -3 ~ ;;, oV CO-<.~'- 87 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 tJ~ A~~ .,~ . AGENT/OWNER DATE ADDRESS TELEPHONE #