HomeMy WebLinkAbout0016970-Plumbing (water heater) CITY OF OSHKOSH N2 16970
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /6 C x' PLAN NO.
OWNER a- / 2 /h 7'
DESIGNER
USE /NATURE OF WORK b'CPZC( 7/ %,
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 C 0 A4.-1---
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
/
(712 (712 FEES: Valuation $ ,F)D Permit Fee Paid $ L U Park Dedication $
ISSUED BY 7 Date / — 12 `P4 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE jT a 1//2_/ 1l�
AGENT /OWNER [ TE
ADDRESS
TELEPHONE #