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HomeMy WebLinkAbout0009632-Plumbing (laterals) /� CITY OF OSHKOSH No 09632 `' PERMIT — APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG� SIGN ❑ ZONING FLOOD PLAIN HEIGHT , - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � PLAN NO. OWNER DESIGNER . i USE/NATURE OF WORK SC��!� y w i.�: - ���j/-vt__ � 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 �' L �1., � —BT _WH _Disp WSoft —CBasin —Lav —Sh —DW _DF �San. Sewer 7`y �vC —WC —FDr _SP —Ur �Storm Sewer � ��� —Sink _LTub —Eject —SS �Water � �� �,,�`}�-- Other �j��, � � FEES: Valuation $��� " " P rmit Fee Paid $ ' Park Dedication $ ISSUED BY Date Final/O.P. In the performance of this work I agree to perform all work pursuant to rules gov ning the described construction. SIGNATURE -� O AGEN /OWNER DATE ADDRESS TELEPHONE#