HomeMy WebLinkAbout0043213-Plumbing (kitchen sink) L-110
CITY OSHKOSH
43213
OF OS OSH
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 4X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS_ CZO 4 t I M uX\{CL PLAN NO.
OWNER Jail Y i R A 7
DESIGNER 1 nn
USE/NATURE OF WORK, I �kC OJ .kae \no `
�(1 Sunk
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 5arnrnc Y1„ 5
- BT _ WH _ Disp _ WSoft — CBasin
_ Lav Sh _ DW _ DF — San. Sewer
- WC _ FDr _ SP _ Ur _ Storm Sewer
+ Sink _ LTub _ Eject _ SS — Water
Other
FEES: Valuation $ LOw I Permit Fee Paid $ �V , on Park Dedication $
ISSUED BY Date //3 7 S .-- Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATU
AGENT /OWNER DATE
ADDRESS (--
TELEPHONE #