HomeMy WebLinkAboutPlumbing (laterals) CITY OF OSHKOSH N9 00516
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG cZ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / (a'd �vGV)?i1 / /7 �p/ P
'' ,.,,( 1 PLAN NO.
/
OWNER C .... �l i• % 1s /711/710 -S
DESIGNER
USE /NATURE OF WORK
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 p Circuits
PLUMBING CONTRACTOR VO�yi.t i C---- f
— BT — WH _ Disp WSoft
CBasin
—Lav _Sh —DF
— DW — San. Sewer '�
— WC — FDr SP Ur
Storm Sewer
— Sink — LTub
— Eject _. SS
Other —Water rcyr
FEES: Valuation $ r/
Permit Fee Paid $ /6"------ Park Dedication $
ISSUED BY °-e-Y Date
---* /cree Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 0 leat ,����%� �
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #