HomeMy WebLinkAbout0027963-Plumbing (water heater) 4.) CITY OF OSHKOSH N°_ 27963
- PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG [ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /4) 6 n e PLAN NO.
OWNER �-
DESIGNER
USE /NATURE OF WORK 4 . (+
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 G
BT 1 WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ .c' c' - f' C) Permit Fee Paid $ / ° ' ° 0 Park Dedication $
ISSUED BY Date A/2
Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE - 6��"�7'` _607,- y -9 L
AGENT /OWNER DATE
ADDRESS
TELEPHONE #