HomeMy WebLinkAbout0003934-Plumbing (water heater)/~ CITY OF OSHKOSH No _ 03934
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~l3 GC1 ~~~ PLAN NO.
OWNER
USElNATURE OF WORK ~ ~~ '" ~ ~
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
Fixtures Switches Receptacles
Volts Amps
Circuits
PLUMBING CONTRACTOR ~ ~ ~ .~_2~,y~,~
- 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 $ ~~~~ Permit Fee Paid $ ~~_ Park Dedication $
ISSUED BY _ ~„~ Date Final/O.P.
In the pertormance of this work 1 agree to pertorm all work pursuant to rules governing the described construction.
<; ~ ~ 1
SIGNATURE -"~'~
t
• AGENT/OWN DATE
ADDRESS
TELEPHONE #