HomeMy WebLinkAbout0008002-Plumbing /4 ) _CITY OF OSHKOSH N2 08002
PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGO SIGN ❑ ZONING FLOOD PLAIN HEIGHT
40
ADDRESS _ / 411° . -_� PLAN NO
OWNER J7YL`
DESIGNER
USE /NATURE OF WORK / a- e /��jil
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 107 7
BT WH Dis( WSoft CBasin
+ Lav Sh DW DF San. Sewer
' WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
/ craw V FEES: Valuation $ / 5-� P it Fee Paid $ AP 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 A '461 �
`i AGENT/ NER� DATE
ADDRESS
TELEPHONE #