HomeMy WebLinkAbout0017693-Plumbing (water heater) CITY OF OSHKOSH N° 1
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ,K. SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /Z J JL 12 /Tc/r PLAN NO.
OWNER /ors L • �reirU1"
DESIGNER
USE /NATURE OF WORK %C
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 (5 F1 ?J /Yl /b1
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 $ 37 °�
03 /
S P erm i t Fee Paid $ !� Park Dedication $
ISSUED BY Date T Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE tt vie.; f P
AGENT /OWNER DATE
ADDRESS
TELEPHONE #