HomeMy WebLinkAbout0005657-Plumbing
~
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N2
05657
TYPE:
BLDG D HTG D ELEC D PLBG ViI SIGN D ZONING - FLOOD PLAIN- HEIGHT-
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
OWNER
~~Š7Zc¿
PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
~"P-r'~~ ,<;;,? /~<z/r~ ~~j/;'J
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEAliNG CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
New D Change D Temp D
Type- Volts- Amps-
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
-/--BT
---.!....Lav
íwc
-----L Sink
?r. ~ #:-ç
--I--- WH
-Sh
-----1 FDr
+ L tbs...
_Disp
_WSoft
- CBasln
- San. Sewer
_DW
-I-SP
_DF
_Ur
- Storm Sewer-
_Eject
_SS
_Water
Other
2 ~~/
FEES: Valuation ~~ /ermit Fee Paid $ ~ . ~
ISSUED BY ~ Date ~9
r
Park Dedication $-
Final/O.P. ~'/ð'7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE r:,é C d zJ di:::uo 1t & ') 'J.-S
AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
NATURE OF WORK
¿?~!¡f~;Z~
We-<..,) S?
PLUMBING PERMIT APPLICATION
DATE - . ~//Sl
PLUMBER t:Á..-!¡ ðev r
PERMlT it 5'1:57
ADDRESS
OWNER
SAN SEW I , I 1 iF iF
WATER I I I I I athtub If) Catch Basin
STORM SEW I I I I I 'Lava tOry m Grease Trap
I Toilet ¡f1 J Sump Pump
INSPECTION DATE INSPECTION DATE Kit Sink '-' Local Waste
Î /2 ó'h7 Sink(other) Site Drain
l1t Shower I Laundry Stand p~pe
& I Floor Drain 'Laundry Tray
(L tl'(~~) ?hl>" Disposal Wat. Softner
¡If f'f¿,- cUl-ll/~1 Dishwasher {. j 'D. Founta~n
I Watèr Rea ter Ejector
Urinals Future outlets
NEW
RELAY
REPAIR
INTERIOR
1** Violation notes on reverse side!