HomeMy WebLinkAbout0039354-Plumbing (lateral)/~ CITY OF OSHKOSH No
`' PERMIT -APPLICATION AND RECORD
2--
39354
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS l~' PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft.
Foundation
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
Heat Loss
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps
Fixtures Switches Receptacles Circuits
BTU'S
PLUMBING CONTRACTOR ~l
- BT - WH - Disp - WSoft - CBasin ~i/
- Lav - Sh - DW - DF -San. Sewer
- WC - FDr - SP - Ur -Storm Sewer
-Sink - LTub -Eject SS -Water
Other
FEES: Valuation $ ~-~6 ~ ~ ~ O Permit Fee Paid $ ~_'~ d
ISSUED BY ~ Date S ~° i
Park Dedication
Final/O.P.
In the pertormance of this work I agree to pertorm all work pursuant to rules governing the described construction.
SIGNATURI= ~ f~ ~~/
~ AGENT/OWNER /~.-- D E i~
ADDRESS ~~~ ~~~ ~-~ ~/ ~ ~~4--~~C/
TELEPHONE #
# Rooms # Stories
Class of Const.
Height .
Occupancy Permit