HomeMy WebLinkAbout0034111-Plumbing (water heater) ��`
� CITY OF OSHKOSH N° 34111
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG� SIGN ❑ ZONING FLOOD PLAIN HEIGHT f
ADDRESS 3f �' r � T f/ PLAN NO.
OWNER � v
DESIGNER
USE/NATURE OF WORK
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
_BT �WH —Disp —WSoft —CBasin �
—Lav _Sh —DW —DF —San. Sewer
—WC —FDr —SP —Ur —Storm Sewer
—Sink —LTub —Eject —SS —Water
Other
�
FEES: Valuation $ �g�' � � Permit Fee Paid $ �� ` � � Park Dedication $
ISSUED BY � Date `S '�sr / � Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE v �2� � �
�. AGENT/OWNER DATE �.
ADDRESS
TELEPHONE#