HomeMy WebLinkAbout0016251-Plumbing (laterals) CITY OF OSHKOSH N2 16251
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG J2K SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS P L SAer - y - e4./c777./ e4./c777./ PLAN NO.
OWNER /jP I/P Y Clue .
DESIGNER
USE /NATURE OF WORK 5-C�iC.iC� eit�t 0 / (il/Z7.4� / 4
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 r `'YU 1--- LCi 107.
Lc
BT WH Disp WSoft CBasin
_Lay Sh DW DF / San. Sewer V cl /// e--
WC FDr SP Ur Storm Sewer /
Sink LTub Eject SS Water l 4 /Cr p-a--
Other
d�
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/ V
FEES: Valuation $ l v v 0 Permit Fee Paid $ .,..e® 4771 Park Dedication $
ISSUED BY Date ///7/ Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ,2_ " I'AY " / lir'
"—A.
AGENT /OWNS• DATE
ADDRESS
TELEPHONE #