HomeMy WebLinkAbout0040986-Plumbing (laterals) CITY OF OSHKOSH N � 40986
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGX SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ` 4 ■S - 7 V - / /PLAN NO.
OWNER o _ • , 1 4 ,Q \
DESIGNER , /
USE /NATURE OF WORK ���1 — / _L._i! i WARP , /
,Z.,,,/ .jP
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
- BT _ WH _ Disp _ WSoft — CBasin
- Lav _ Sh _ DW — DF — San. Sewer
— WC _ FDr _ SP _ Ur ( Storm Sewer v
— Sink _ LTub _ Eject _SS — Water
Other
FEES: Valuation $ ' � Permit Fee Paid $ /o 4::,--6 / Park Dedication $
ISSUED BY � Date g / /'� Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE t-QA_Alleit / J1.A. M P 5 o3 3 G 2 t r -
AGENT /OWNER DATE
ADDRESS 5-1 ? 1A1 , IA/ at U kl L /1 (J 6 V St 'r 3 s 333 f
TELEPHONE #