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HomeMy WebLinkAbout0021100-Plumbing (standpipe & lav) ~ CITY OF OSHKOSH N~ PERMIT - APPLICATION AND RECORD 21100 TYPE: BLDG D HTG D ELEC D PLBG ~ SIGN D ZONING - - - - - - - - - - - - - - - - - - - - - - - -..if - - - ~; - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS /"7b 0 ~~ ~ PLAN NO. D en- ~ a--J , FLOOD PLAIN HEIGHT OWNER DESIGNER -r.. USE/NATURE OF WORK /l, ( . W, ~ ~ t . , BUILDING CONTRACTOR Size Foundation , Sq. Ft. # Rooms # Stories Height Occupancy Permit Class of Const. HEA1;JNG 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 T J f4J~~ _BT --L Lav _WC _WH _Sh _Disp _DW _ WSoft _DF _ CBasin wfl'C- _ San. Sewer _Sink Other _FDr _SP ~-b+i;b lI.c.w __ Eject _Ur _ Storm Sewer _SS _ Water Permit Fee Paid $ Date /o..c:JC ( ,v/.?t :l/~iJ / / Park Dedication $ FEES: Valuation $ 30 <:) ,00 ISSUED BY . t! ~ C~f!,~' Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE ---/-:- ~ /t1-;9-o -96 AGENT/OWNER DATE ADDRESS TELEPHONE # . . . PLUMBIJG PERMIT APPLICATION ADDRESS 17 ~ Q l~. C* DATE "!. - I 'f - tt 0 PERMIT# c;>) /" 0 OWNER' O~ _ __ PLUMBER _P....D a. II ie .1. . ~ATtJRE OF WORK ~C\.~. t"Y\~~~~i"- ~~~d ~~\r~."..~ S~~".k. ~AN SEW # iF WATER Bathtub Catch Basin ~"O'R..."'! SEW Lavatorv Grease Trap Toilet S umn Pump INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste 3/~o;9o \ Sink(other)-P~.,:T Site Drain t<F Shower Laundry Stand Pl.pe Floor Drain Laundry Tray Disposal Wat. Softner Dishwasher D. Fountain Water Heater Ejector TT.,.inals Future outlets NEiol RELAY REPAIR INTERIOR 1** Violation notes on the reverse sidel -.J 1111