HomeMy WebLinkAbout0040321-Plumbing (water heater) CITY OF OSHKOSH N9 4032
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 2155 Men njc "Ph \ 9,, PLAN NO.
OWNER jYl 'mil C no Q Q
DESIGNER
USE /NATURE OF WORK U.140. 1n 11.9 (Far
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 C J N\A(Y\(JY)
- BT _X WH Disp WSoft CBasin ,h -
- Lav Sh DW DF San. Sewer
WC FDr SP Ur — Storm Sewer
Sink — LTub __ Eject — SS __. Water
Other
FEES: Valuation $ A J. P wit Fee Paid $ /D. 00 Park Dedication $
ISSUED BY Date ` 9y Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #