HomeMy WebLinkAbout0027105-Plumbing (interior)
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CITY OF OSHKOSH N~
PERMIT - APPLICATION AND RECORD
27105
OWNER
DESIGNER
USE/NATURE OF WORK
;r)~ S Ff<
LLp?
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
I
HEATING CONTRACTOR
Heat 0 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
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,- PLUMBING CONTRACTOR
L
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_Lav
_WH
_Sh
_ WSoft
_ CBasin
_ San. Sewer
wtfL-
_BT
_Sink
Other
_FOr
_ LTub
_OW
_SP
_OF
_WC
_Ur
_ Storm Sewer
_ Eject
_SS
_ Water
FEES: Valuation $ /.2, CJ 6 CJ. C 0 Permit Fee Paid $
ISSUED BY W ~ Date
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9"'lS. D d y'
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Park Dedication $
Final/O.P.
5'"~f)) ~9d
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
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0- ~
- ~WNER
DATE
ADDRESS
TELEPHONE #
. L PLUMBtNG PERMIT APPLICATION
ADDIlESS. ;20 bS:!~.U' DATE I ~- 1(,- '11 PE1lIIIT#?- 71 () ~
CA/IlER ~.-Lt .~'-"-- .~.IJlIlB ERfL. L 0 d
NATURE OF WORK /U~ s- P ~ - ~ 1-',- . t
NEty RELAY REPAIR INTERIOR
SAN S'EW
WATER
fF
INSPECTION DATE INSPECTION DATE
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f** Violation notes on the reverse sideJ
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