HomeMy WebLinkAbout0001860-Plumbing (laterals)� �.
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/� CITY OF OSHKOSH N° 01860 �
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PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG!� SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS PLAN NO.
OWNER t J n 1fi'7a�K_, ., r�,. �.• Q��.�-.Y 4
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DESIGNER
USE/NATURE OF WORK
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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
—Lav —Sh _DW _DF !�'San. Sewer ���j C�, ��
—WC —FDr _SP _Ur �Storm Sewer
—Sink _LTub —Eject _SS �Water
Other
FEES: Valuation $ �� 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#