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HomeMy WebLinkAbout0002861-Plumbing (water heater) n _ CITY OF OSH KOSH No _ 02861 PERMIT APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG�SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �T� Z l L� ��� PLAN NO. OWNER �� 1�Z �-,.-- DESIGNER : USE/NATURE OF WORK ,�`���,T_�/E�.!.��,������-a.- 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 �..tit� '��'�--�✓ —BT J WH —Disp WSoft —CBasin —Lav _Sh _DW —DF —San. Sewer —WC FDr —SP Ur Storm Sewer —Sink —LTub —Eject —SS —Water Other �-.� - ����_.... FEES: Valuation $ '� v Permit Fee Paid $ Park Dedication $ ISSUED BY� r��,,� Date � Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. a . � SIGNATURE '`"�----' A /OWNER DATE ADDRESS TELEPHONE#