HomeMy WebLinkAbout0022181-Plumbing (toilet)
~
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N~
22181
TYPE: BLDG 0 HTG 0 ELEC 0 PLBG}tf SIGN 0 ZONING - FLOOD PLAIN- HEIGHT-
~~~;E~~ - ---;;;;-;:~- - -,-- ---- ----------~L~~~~--------- --
F ~ ¿: ----~
OWNER
DESIGNER
~~~~e-d~
(I
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. F!.
# Rooms
# Stories
Height
Occupancy Permit
Class of Cons!.
-'
HEATING CONTRACTOR
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU.S
ELECTRIC CONTRACTOR
Electric Servo
New 0 Change 0 Temp 0
Type- Volts- Amps-
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR ?~::J.;r.-
_BT _WH _Disp
_Lav
-.L wc
-Sh
_DW
-SP
_WSoft
_DF
- CBasin
- San. Sewer
w/'C-
_FDr
_Ur
- Storm Sewer
_Sink
Other
_LTub
_Eject
-SS
_Water
FEES: Valuation $ /' :s-o .-6 G
ISSUED BY W ~~¿u:.;
Date
/'ù - <Z:>--c::>
///7/;7/
/ /
Park Dedication $
Permit Fee Paid $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE Q~-4<---
AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
ADDRESS
OWNER
ING PERMIT APPLICATION
DATE
PLUMBER
PERMIT if ,?-;1.-/'i¡
NATURE
SAN S¡¡W I I I I if I if
WATER I I I I ß3athtub ' Catch Basin
STORM SEwl I I I Lava torv Grease TraD
¡ / Toilet Sump P1,lmp
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
Sink(other) Site Drain
Shower Laundry Stand p1pe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Founta1n
Water Heater Ej ec tor
Urinals Future outlets
NEW
RELAY
REPAIR
INTERIOR
1** Violation notes on reverse sidel