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0040762-Plumbing (sump pit & pump)
~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD y~ N~-40762 TYPE: BLDG 0 HTG 0 ELEC 0 PLBG)i SIGN 0 ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - OWNER \ ,;J() , Htl1' f(\Qn ~~. <.4xnm(l1J) G-oJf\a D PLAN NO. ADDRESS DESIGNER USE/NATURE OF WORK c' ) JXlS:m9.D C\LlJ'N\~ _flt ~ 'fUtVVl{) BUILDING CONTRACTOR Size Foundation Sq. Ft. # Rooms # Stories Height Occupancy Permit Class of Const. 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 PLUMBING CONTRACTOR ~(\l) f'l'<\ 1..\.l)I\QJYl _ BT --L WH _ Disp _Lav _Sh _OW _WC _FOr Lsp _Sink _ L Tub _ Eject Other _ WSoft _OF _ CBasin ~ _Ur _ San. Sewer _ Storm Sewer _SS _ Water FEES: Valuation $ ~Cf). <..'0 ~ ISSUED BY / Permit Fee Paid $ / O. 0 {) v/ . ~rk Dedication $ Date.:]- ~ t /l,ct'fFina'/o.p. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE 1- f~ AGENT/OWNER i-I/-?<t DATE ADDRESS TELEPHONE #