HomeMy WebLinkAbout0032789-Plumbing (bathroom)
~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
~/V
32789
:~:E~~ BL~~ _~ _ ~T~; ; ~~:C _ ~~~;; ~_ :~~D_ ~LA:~~ ~~_ _ HEIG~_ _ _ _ _
6-7 LG~~
~~ Ar-r-we.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat 0 NC 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
-.LBT _WH
~Lav _Sh
-Lwc _FOr
/tf-y;;;
~
_OW
_SP
_ WSoft
_OF
_ CBasin
_ San. Sewer
_Ur
_ Storm Sewer
_Sink
Other
_ LTub
_ Eject
_SS
_ Water
FEES: Valuation $
13DO.OO
~
Permit Fee Paid $
Date
IdA .0(;)/
;L-.~2--73
Park Dedication $
Final/O.P.
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE r ~~
DATE
ADDRESS
TELEPHONE #