HomeMy WebLinkAbout0032743-Plumbing (laterals) eof
CITY OF OSHKOSH N° 32743
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBGJ SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS ki, 4 PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK A �J
,'e_-;
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 ��"'"'t''
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer V 1) c
WC FDr SP Ur 1 Storm Sewer T e V C
Sink LTub Eject SS Water r
Other
FEES: Valuation S O Permit Fee Paid 3 6 0 0 L Park Dedication
ISSUED BY Date -Z 2 7 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ti-A ,I7 r
AGENT /OWNER DATE
ADDRESS
TELEPHONE