HomeMy WebLinkAbout0030072-Plumbing (laterals)O CITY OF OSHKOSH N? 30072
~' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS 7 7 Q ~ R - - - - - - - - - - - - - - - - - ~i nni non - - - - - - - - - - -
OWNER ~ /1~I !~ -~`y~-/l~~
DES
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft
# Rooms
# Stories Height .
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
Fixtures Switches Receptacles .
PLUMBING CONTRACTOR
-BT -WH
Lav _ Sh
- WC _ FDr
- Sink LTub
Other
Volts Amps
Circuits
- Disp _ WSoft _ CBasin ~L /~
- DW _ DF ~ San. Sewer j r ~C
SP _ Ur _ Storm Sewer
-Eject _ SS ~ Water ~ ~'`""
FEES: Valuation $ ~ ~ d • ~ ~ Permit Fee Paid $ ~ D Q 0 Park Dedication $
ISSUED BY ~ Date ~ ~ ~ Z Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE o~ d ~/a - S,L.
AGENT/OWNER DATE
ADDRESS S) ~~ P ~ ~~.~- J~~ ~ c~,/f'-~-~ ~ ~ j S`py` ~ l ,P s = S-`~G~
TELEPHONE #