HomeMy WebLinkAbout0011678-Plumbing CITY OF OSHKOSH N9 11678
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGIgt SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS // G'v /o77C PLAN NO.
OWNER / 6
DESIGNER
USE /NATURE OF WORK / / . f - 7i„y
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 C51-14
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
t Sink LTub Eject SS _ Water
Other
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FEES: Valuation $ ,5 ''''r
Fee Paid $ -6 -‘t:44-- Park Dedication $
ISSUED BY GQ�� Date 42 -/ 1 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 1 --A. . .... _�' � ���''* 12_/ 7.1j?
AGENT /OWNER
D ATE
ADDRESS •
TELEPHONE #