HomeMy WebLinkAbout0021133-Plumbing (water heater)_CITY OF OSHKOSH N°_ 21133
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ,Q ]~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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q 7`fi
ADDRESS ~' ~~ ~"~ ` / PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
LJ ~ ~y~
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
BT WH
Lav Sh
WC FDr
-Sink _ LTub
Other
U
Disp
DW
SP
-Eject
WSoft
DF
Ur
SS
- CBasin
-San. Sewer_
-Storm Sewer
-Water
FEES: Valuation $ ~~ ' ~ ~ Permit Fee Paid $ ~ v ` O y Park Dedication $
ISSUED BY ~ ~~~-°Y Date ~~/'~ ~/ ~~ Fi
l/O
P
na
.
.
In the pertormance of this work I agree to pertorm all work pursuant to rules governing the described construction.
SIGNATURE
ADDRESS
Q .~ -gig
C.
%a 'd
DATE
TELEPHONE #