HomeMy WebLinkAbout0024278-Plumbing (addn fixtures)
~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
24278
OWNER
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D NC 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
w ~Le-y
_BT
_WH _Disp
:2-::
_Sh _OW
~FDrl~)_SP
L L Tub _ Eject
_ WSoft
_OF
_ CBasin
~
_Lav
_San. Sewer
_WC
_Ur
_ Storm Sewer
_Sink
Other
_SS
_ Water
/g6e...~ 0
FEES: Valuation $ ~'
ISSUED BY W
Permit Fee Paid $
Date
: /
;#- y:; <:> 0 V'
7-/b -9/
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~~ 4. ~"-r
AGENT/OWNER
~
4-l~... Gll
DATE
ADDRESS
TELEPHONE #
ADDRESS
OWNER
NATURE
7-tf;z 7%
SAN SEW' iF 1F
WATER Bathtub Catch Basin
".,.n~M ,,'Ftl I Lavatory Grease Trap
Toilet I Sumo Pumo
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
p o -If~ '?t Sink(other) Site Drain
v Shower Laundry Stand P1.pe
~ Floor Drain ( " ~. -, j Laundry Tra..,
Disnosal 11/ Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
n",inal,:l Future outlets
RELAY
~
REF AIR
r** Violation notes on the reverse sidel