HomeMy WebLinkAbout0026473-Plumbing (water heater)_CITY OF OSHKOSH N° 26473
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS _ °~ ~~ ~ S ik i ins " ~'~ n PI PLAN NO.
OWNER pQ/Q ~r~o rf ~~Qc'
DES
USE/NATURE OF WORK~~..~9~r Q~~-¢r
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation .Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR Sce.•rwrv~mti~
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- BT -.~ WH Disp _ WSoft CBasin
Lav Sh _ DW _ DF -San. Sewer
- WC FDr SP Ur -Storm Sewer
-Sink LTub -Eject SS Water
Other
FEES: Valuation $ S `~`l. S a Permit Fee Paid $ I D • ~ ~ Park Dedication $
ISSUED BY C~J "`-~ Date ~ Z - ~ o ~ l Final/O. P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~~
AGENT/OWNER DATE
ADDRESS
TELEPHONE #