HomeMy WebLinkAbout0016444-Plumbing (repair water service) CITY OF OSHKOSH N° 16444
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG g( SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 7< S O PLAN NO.
OWNER /. /6yQ 7
DESIGNER /
USE /NATURE OF WORK Jew �
(�a7g— Spvv /c '
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 Ar/61
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
"° cro A /
FEES: Valuation $ , ) Permit Fee Paid $ /0 Park Dedication $
ISSUED BY 7i2../-- Date # - 70 0 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 4 9
AGENT /OWNER DATE
ADDRESS
TELEPHONE #