HomeMy WebLinkAbout0032979-Plumbing (relay water service) T" � �
n CITY OF OSHKOSH N° 32979
`' PERMIT - APPI�ICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN ❑ ZONING FLOOD PLAIN HEIGHT
/
ADDRESS /C��' � � ��`"'� C � PLAN NO.
OWNER �•� ` Z.."" �
DESIGNER
USE/NATURE OF WORK ✓`�'`t �'•����`'"
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
M 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 l Water
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Other
FEES: Valuation $ �C� C,� c` Permit Fee Paid $ / C � c G\ park Dedication $
ISSUED BY � Date � � ��– �-� Final/O.P.
In the performance of this work I agree to perform alt work pursuant to rules governing the described construction.
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SIGNATURE /
AGENT/OWNER DATE
ADDRESS_- � � �� v�. wa �JICG Cl ! f �(� l J�J'� 02� `
TELEPHONE#
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!: WAIER " Bat3itub Su Pu
Lri►sto E"ector
oilet Water Softener
� ���� �� �t• g� Drinkin Fountain
�'��_-���:%% �,,�' !; /��,�r :�'t,,,_� S iak o ther
- - ,� W t e te Slo Sink
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- Floor Drain Local Waste
Laundry u Site Drain
Dis osal Laundr Stand i e
Dishwasher Catch Basin
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