HomeMy WebLinkAbout0009494-Plumbing
~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
09494
TYPE: BLDG D HTG D ELEC D PLBG ~ SIGN D ZONING
FLOOD PLAIN
HEIGHT
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
OWNER
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(_)~A L ~a<-.e~
PLAN NO.
ADDRESS
DESIGNER
~~-je.,-- O(,~-,/ (A/=~< 4~-6
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
Fixtures
New D Change D Temp D
Type _ Volts _ Amps_
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR ~~ T P y"Jc C</1 -Mo 3
_ BT _ WH _ Disp _ WSoft
_Sink
Other
_ Eject
_SS
_ CBasin
I < /" Ov('"
-'- San. Sewer 't- /L.!:. L
_ Storm Sewer
--L Water I a c C7Y ~6--
_Lav
_Sh
_FDr
_ L Tub
_DW
_SP
_DF
_WC
_Ur
FEES: Valuation $
ISSUED BY
Permit Fee Paid $ / ~-o
Date' .../~6M
Park Dedication $ ~
Final/O.P. 6//1."
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~~01 t:c#~~~
\ AGENT/OWNER
7- 2..~,-ff
DATE
ADDRESS
TELEPHONE #
OWNE R
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J> Pyn<B,NS' PERMIT APPLl. CATION 0
1't'5T' ~/~ DATE S2 !
,.~/1 ~e?€,L PLUMBER ..
5'~ $<ro-v
RELAY REPAIR
PERMIT# tJ119'/
.
ADDRESS
NATURE OF WORK
SAN SEW
WATER
TORM SEW
NEH
L(~
INTERIOR
if:
:{.f
INSPECTION
DATE
Bathtub
Lavator
Toilet
Kit. Sink
Sink(other)
Shower
Floor Drain
Dis osal
Dishwasher
Water Heater
rinals
Catch Basin
Grease Trap
Sum Pum
Local Waste
Site Drain
Laundry Stand Pipe
Laundr Tray
Wat. Softner
D. Fountain
Ejector
Future outlets
..,
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** Violation notes on the reverse side