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HomeMy WebLinkAbout0044871-Plumbing (laterals) �-f o I � CITY OF OSHKOSH N° 44871 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG� SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - • - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS PLAN NO. OWNER ��llo�g�L�- DESIGNER USE/NATURE OF WORK - Ritl BUILDING CON7RACTOR 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 _BT —WH _Disp —WSoft —CBasin y _Lav —Sh _DW —DF �San. Sewer � _.WC _FDr —SP —Ur —Storm Sewer � —Sink _LTub —Eject —SS �Water Other FEES: Valuation $ � Permit Fee Paid $ Park Dedication $ ISSUED BY Date FinaVO.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE ���w�� ��������'" ���� AGENUOWNER DATE ADDRESS �`r`'a�/ S'<�.z.- -�C C� � ' y�y S�� 3��- TELEPHONE N