HomeMy WebLinkAbout0034298-Plumbing (relay water service) �
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� CITY OF OSHKOSH N°- 34298
`' PERMIT - APPLICATION AND RECORD
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TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN ❑ ZONING FLOOD PLAIN HEIGHT �;
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ADDRESS �6 ��' �'1 PLAN NO.
OWNER ���- �
DESIGNER
USE/NATURE OF WORK � ��"– � `
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
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HEATING CONTRACTOR
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Heat ❑ A/C ❑ Vent ❑ FueUSystem Heat Loss BTU'S
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ELECTRIC CONTRACTOR �
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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
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Other
FEES: Valuation $ ���� • � � Permit Fee Paid $ `�o '"� � Park Dedication $
ISSUED BY �— Date � �� 9� Final/O.P.
, In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE , ` ������ ��.�/93
AGENT/OWNER DATE
ADDRES
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