HomeMy WebLinkAbout0023935-Plumbing (drain/waste)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N2
23935
TYPE: BLDG 0 HTG 0 ELEC 0 PLBG ~ SIGN 0 ZONING - FLOOD PLAIN - HEIGHT-
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OWNER
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BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
Fixtures
New 0 Change 0 Temp 0
Type- Volts- Amps-
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR {}
~BT _WH
.#
f='~
_Lav
Lwc
-Sh
LFDr
LLTtIb,<f('N
_Disp _WSoft -CBasin
_DW _DF - San. Sewer
_SP _Ur _Storm Sewer
_Eject -SS _Water
w",Æ:-
_Sink
Other
FEES: Valuation $
ISSUED BY
Permit Fee Paid $ I {, , 0 ð
Date (; ~.2-ð -9/
Park Dedication $
Final/O.P. (" - ;;¡ (" - 9/
In the performaðe of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURJ) êW4~P ~ ~ C/Jj/c)¡
AGENT/OWNER DATE
ADDRESS
TELEPHONE #
PLUMB!NG PE~~T APPLICATION
ADDRESS .s ~~ ~ ~ ~ 0 DATE C - /;7'- 7'/ - PEP; fiTI,I .7 3'1 3 5'
OWNER F ~ PLUMBER IJ r ~. ~
NAIURE OF WORK . - ~ ~ ~ of- ~~~.IJ -
NE1. RELAY REPAIR INTERIOR
SAN SEW I I I I IF IIF
WATER ¿ Bathtub Catch Basin
~1'nllM ~1"!J I Lavatorv Grease Trap
I Toilet I SumoPumo
INSPECTION DATE INSPECIION DATE Kit. Sink / Local Waste
Sink(other) Site Drain
1= b -.2 ¿ Shower Laundry Stand P1pe
T Floor Drain Laundrv Tra7
Disoosal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
"-'~a s Future outlets
(I) '~L..J-..
J** Violation notes on the reverse side!
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