HomeMy WebLinkAbout0041989-Plumbing (dishwasher) Iv
CITY OF OSHKOSH N9 41989
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC p PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 1/ (3C) W 1 Cit J -P Q M (5'• PLAN NO.
OWNER i tY1 W ,I Liyxr
DESIGNER
USE /NATURE OF WORK k' ),TMICIaliift &Mr iwa cl ,p
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 ?Op
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 $ /5/C30 Permit Fee Paid $ /6, « Park Dedication $
ISSUED BY Date Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #