HomeMy WebLinkAbout0043379-Plumbing (water heater) t-- I I I
CITY OF OSHKOSH No- 4 3379
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS la 1 'km OfVOE.' , PLAN NO .
OWNER eM i () tOf
DESIGNER `� ` , ,,
USE/NATURE OF WORK `9 ?la .PD d l In `FC.( . ) 4 (kr
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 "RaArnU.N.Q f
____BT _L WH — Disp _ WSoft — CBasin
_ Lav _ Sh _ DW _ DF — San. Sewer
- WC _ FDr _ SP _ Ur _ Storm Sewer
- Sink _ LTub _. Eject SS _Water
Other
FEES: Valuation $ L OD Permit Fee Paid $ �0 0 Park Dedication $
ISSUED BY � Date / // ,' L Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE cis, 1.^'v"""" H 7 q
AGENT /OWNER DATE
ADDRESS
TELEPHONE #