HomeMy WebLinkAbout0040671-Plumbing (water heater)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N~ 40671
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ADDRESS
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PLAN NO.
OWNER-fJ\Ct(\!
DESIGNER
USE/NATURE OF WORK 'KO P~QQ Q U.JO:tQ(' k\Q (i-t-OX""
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 '\\c\sffi\),<1SeXl
_BT ~WH _Disp
_WC
_FOr
_ L Tub
_Ur
_ CBasin
_ San. Sewer
_ Storm Sewer
_ Water
~
_Lav
_Sh
_OW
_SP
_ WSoft
_OF
_Sink
Other
_ Eject
_SS
FEES: Valuation $ .3..c;n I OV
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ISSUED BY
/
Permit Fee Paid $ 10. ot) ../ a::z Pari< Dedication $
Date ~"t'!14 Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE d' f!jL'_'~~,",,,,,,,,,"
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DATE
J-g3 ....67 Y?
ADDRESS
TELEPHONE #