HomeMy WebLinkAbout0017633-Plumbing CITY OF OSHKOSH N° 17633
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG iel SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS v 3 p S4zn- p--,,,T._ , PLAN NO.
OWNER iG i Zee Z c //C S
DESIGNER
USE /NATURE OF WORK ,Sl-Zq .rte < 4
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 El Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 4?■</Z ria∎t. k'i
t . BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
3 WC ks FDr SP Ur Storm Sewer
2. Sink 3^ / LTub Eject SS Water
Other /- Avvr 0
o" , 6 4J pa
FEES: Valuation $ . 3 6 . Permit Fee Paid $ Park Dedication $
ISSUED BY Date ''3b -re; Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE at r C:21 ` °
AGENT /OWNER DATE
ADDRESS
TELEPHONE #