HomeMy WebLinkAbout0012475-PlumbingCITY OF OSHKOSH No 12475
PERMIT — APPLICA`TION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG XJ SIGN�o ZONING FLOOD PLAIN HEIGHT
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ADDRESS �� /�� PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK ` >C'� L� L�l-r2 4—
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
PLUMBING CONTRACTOR —0
BT
WH
Lav
Sh
WC
FDr
Sink
LTub
Other
Volts
Circuits
Height.
Occupancy Permit
BTU'S
Amps
Disp WSoft CBasin
DW DF San. Sewer "T (L°�
SP Ur Storm Sewer
Eject SS Water H � 4
FEES: Valuation Permit Fee Paid $Q Park Dedication $
ISSUED BY -- Date 3 ;7 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE T &! %`'�Z.d-
DATE
ADDRESS
TELEPHONE #
METER(S) PERMIT
Name of Owner
Address of owner
Meter Installed At
Meter(s) Size
Meter(s) Use
I F
(DiAgram of Use)
Date
Meter will be installed and used according to the above information,
owner or Agent'
To Water Utility: Requirements have been met to purchase and
install meter(s) at the above address for size and use indicated.
Plumbing Inspector