HomeMy WebLinkAbout0030362-Plumbing (water heater) (4) CITY OF OSHKOSH N° 30362
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS //lf,) (mot/ /azIt PLAN NO.
OWNER CI
DESIGNER
USE /NATURE OF WORK t( 1'ia) , lJ
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 x1,1'1 %1 / _ _ ' 111. I / /./
BT &.NH Disp oft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ ( S - 6 -1/5 Permit Fee Paid $ Oe Park Dedication $
ISSUED BY Date `'-� Z Final /O.P.
7 0
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AG NER DATE
ADDRESS
TELEPHONE #