HomeMy WebLinkAbout0017975-Plumbing (abandon laterals) CITY OF OSHKOSH N°_ 17975
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 020D� Jf/ fl 27 fj 4 PLAN NO.
OWNER h% 4 t om_ va-d. r +''/t.
DESIGNER
USE /NATURE OF WORK d - ? ■ - , - Ar
,
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 v �itr.i 4/r' j
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
at,
FEES: Valuation $'' . > Permit Fee Paid $ CL) Park Dedication
ISSUED BY _ �. Date -1/ — X 2 Final /O.P.
In the performance of this work I agree to perform all work pursuan ;o rules governing the described construction.
SIGNATURE '"✓1t r
AGENT /OWNER DATE
ADDRESS
TELEPHONE #