HomeMy WebLinkAbout0041030-Plumbing (orders to correct) �/ �
/� CITY OF OSHKOSH N� 41030
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN � ZONING FLOOD PLAIN HEIGHT
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: ADDRESS � � �-�� N NO.
OWNER ��- � 1
DESIGNER
USE/NATURE OF WORK o '-
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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 �i��
_Lav _Sh _DW —DF —San. Sewer
—WC _FDr �SP _Ur _Storm Sewer
—Sink _LTub _Eject —SS _ Water
Other
FEES: Valuation $ ��' � a Permit Fee Paid $ ���� � Park Dedication $
ISSUED BY ���A�� Date �r� � Final/O.P. ��
In the performa o ' wor a �,o orm all work pursuant to rules governing the described construction.
StGNATUR��- < -/� G
AGENT/OWNER DATE
ADDRESS � �f r1 � ��• Q�'�
TELEPHONE N