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Home My WebLink About0047574-Plumbing (relay water service) �v� � CITY OF OSHKOSH N°- 47574 : `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN [] ZONING FLOOD PLAIN HEIGHT .� - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � o� �� . 1 G�n I .�11 �S'+'. PLAN NO. OWNER DESIGNER USE/NATURE OF WORK '( -`�-I G�VI ►,c 1 �r �� r�!Ge � 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 S . —BT —WH —DisP —WSoft _CBasin � —Lav _Sh _DW _DF _San. Sewer —WC —FDr _gp _�r _Storm Sewer —Sink _LTub _Eject _SS �Water �-a(�(�.�,r 1 Other � � � FEES: Valuation $ � Permit Fee Paid $ �� Park Dedication $ ISSUED BY Date �� `� �� '' �-S� Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATU AGENT/OWNER DATE ADDRESS 7ELEPHONE N