HomeMy WebLinkAbout0021935- Plumbing (Dishwasher) CITY OF OSHKOSH N° 21935
PERMIT - APPLICATION AND RECORD
TYPE: BLDG E HTG ❑ ELEC ❑ PLBG gr SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS Y/3 ,0 - C{vt—'t PLAN NO.
OWNER S - 0 .-0..-t-c,.--ela
DESIGNER
USE/NATURE OF WORK l 3Z:-,Zei
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 A/0'-J--2/z-a-C ( L . i iz l
-BT WH _Disp WSoft _CBasin Cide-___
-Lay Sh .L DW DF _San. Sewer
WC FDr SP Ur Storm Sewer
-Sink LTub Eject SS Water
Other
FEES: Valuation $ /o1 • C C Permit Fee Paid $ C0' ® d d Park Dedication $
ISSUED BY ye j Date /-'2//,./4) Final/O.P. [012 S1460
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE �G' l e�« ,L))7:-.......:-=4-1"...<-1 C " 11 /'1-/P I‘,1
AGENT/OWNER DATE
ADDRESS
TELEPHONE#
PLUMBING PERMIT APPLICATION
ADDRESS ! 3 `I) . EQJJt -2 33"/7 9 // DATE /0 - 3.-9 c) PERMIT# .2/ '3-5
OWNER �a''m LY/ C 5/- $74' CJ PLUMBER r;-4.4.0./) (_ " . NJchl- .a"`Q,-)
NATURE OF WORK ,u.) n441 ju? I.)5 J
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER4 Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
L /of" /9a Shower Laundry Stand Pipe
Floor Drain Laundry Tray
ci r,1 ,V,/n Disposal Wat. Softner
/ Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
P** Violation notes on the reverse side!