HomeMy WebLinkAbout0005361-Plumbing CITY OF OSHKOSH N2 05361
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG . SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ` LS2 f).c 4x-ti- e ,a PLAN NO.
OWNER ‘-z,. 4 Z__Avz, _
DESIGNER
USE /NATURE OF WORK 4-c 14 `z°�isit,,pd:
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 C4
BT WH Disp WSoft
CBasin
— Lay Sh DW DF
San. Sewer
WC FDr — SP Ur
Storm Sewer
Sink LTub — Eject SS
Water
Other
FEES: Valuation $ ? ` c
c.� �� Permit Fee Paid $ � Park Dedication $
ISSUED BY Date / —�2 --
Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE '. . ��G
A , /OWNER
7
ATE
DATE
ADDRESS
TELEPHONE #