HomeMy WebLinkAbout0016617-Plumbing (cap sewer) CITY OF OSHKOSH N° 16617
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG aH. SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /- r �/ PLAN NO.
OWNER / //40 ,`
DESIGNER
USE /NATURE OF WORK i '':. _ ,t Y_i a " l2 ?/-7L
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ NC ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR _49._
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
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FEES: Valuation $ / Permit Fee Paid $ / — 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.
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SIGNATURE o G
A ENT /OWNER DATE
ADDRESS
TELEPHONE #