HomeMy WebLinkAbout027254 - Plumbing (water heater) CITY OF OSHKOSH N° 27254
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG tA SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /30 M.P. IZ ylc: ;--, PLAN NO.
OWNER IJrI.Aes_ Lye.5 ke
DESIGNER
USE/NATURE OF WORK fz pickea Id N'
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 JC.m me r 'S i I b,
W
BT 1 WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ S 3 L/5- Permit Fee Paid $ /0• 0e> Park Dedication $
ISSUED BY 1-19e___ Date Z , —Y 2- Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
c ---> c ______
SIGNATURE - �'�_
AGENT/OWNER DATE
ADDRESS
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