HomeMy WebLinkAbout0012075-Plumbing (water heater)_CITY OF OSHKOS D RE RD N~ 12075
PERMIT APPLICATION AN CO
TYPE: BLDG ^ HTG ^ ELEC PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~~~ ~ / [ e PLAN NO.
OWNER ~i, ~~ ~jt/ 2 ! / e (` S
DES
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles .
Circuits
Height .
Occupancy Permit
BTU'S
Amps
PLUMBING CONTRACTOR
BT ~1lYH
Lav Sh
WC FDr
-Sink LTub
Other
< t, cz
# Rooms # Stories
Class of Const.
Heat Loss
Disp
DW
SP
-Eject
WSoft
DF
Ur
SS
CBasin
-San. Sewer_
-Storm Sewer
-Water
FEES: Valuation $ ~U~ ~ D Permit Fee Paid $ a - ~ ~ Park Dedication $
ISSUED BY Date ` G ~ Final/O
P
.
.
Volts
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~ ~ ~ ~ ~ ~'
AGENT/OWNER DATE
Sq. Ft.
ADDRESS
TELEPHONE #