HomeMy WebLinkAbout0007366-Plumbing (connect to sanitary sewer) CITY OF OSHKOSH N2 07366
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS �� � S G�a, PLAN NO.
OWNER - mo d- - - 4 Jh—
DESIGNER
USE /NATURE OF WORK r"'crl.1 y, p{, 7 e eS 74-Lc( / Z I to
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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 i - ),
BT WH Disp o ft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other —• `$ rr 0 74, c c -�
vs._., j
FEES: Valuation $ ? Permit Fee Paid $ �/ Park Dedication $
ISSUED BY Date •,.j/ f Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
f- - ∎//
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #