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Home My WebLink About0041436-Plumbing (water heater) s��/ CITY F SHKOSH N° - 41436 � O O PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �� T �l�l�C.� PLAN NO. OWNER "Lll.(�T(� �7L.l�.c.ay�iS�'.�— DESIGNER USE/NATURE OF WORK IJI.)Q�C1 J►14(�i��r 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 �mn�s _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 $ "7�-�� Permit Fee Paid $ � Park Dedication $ ISSUED BY Date � � Final/O.P. In the performance of this work I agree to pertorm all work pursuant to rules governing the described construction. SIGNATURE AGENT/OWNER DATE ADDRESS TELEPHONE M