HomeMy WebLinkAbout0017331-Plumbing (laterals)n CITY OF OSHKOSH N° 17331
L' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG �X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS �C��� (� r PLAN NO.
OWNER
fICC`Il�f�ICO
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System
# Rooms # Stories
Class of Const.
Heat Loss
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type
Fixtures Switches Receptacles
Volts
Circuits
Height -
Occupancy Permit
BTU'S
Amps
PLUMBING C'ONTRAC'TOR
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 $ A)
Park Dedication $
ISSUED BY
Date 1,2 -126? :
c�
C -G Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
621d (J,1VJ � fn?45c
AGENTiOWNER
y.. �
is �11fl'
DATE
ADDRESS
TELEPHONE #