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HomeMy WebLinkAbout0030759-Plumbing (addn fixtures) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD N~ 30759 ~P_E~ _ _ ~L~~ _~ _ ~T~ _ C? _ ~~E~ _ C? _ ~~B~ ~ _ ~I~~ _~ _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS / 7::;;-;;J- I~ 6-~ PLAN NO. S~~~ OWNER DESIGNER USE/NATURE OF WORK F ~~--<:---'~~ ~ l't- ;,,,cbgs "J BUILDING CONTRACTOR Size Foundation Sq. Ft. # Rooms # Stories Height Occupancy Permit ~ 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 _Sink Other _FDr _ L Tub f~-S f'~ _Disp _DW _SP _ Eject _ WSoft _DF _ CBasin ~ PLUMBING CONTRACTOR _BT -'- Lav _WC _WH _Sh _ San. Sewer _Ur _ Storm Sewer _SS _ Water FEES: Valuation $ 3 c C!:> "a l} 1/7 Permit Fee Paid $ Date ISSUED BY '7-,/ S- - ;7 :2- 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 ~ ~A~ ..d rJ, If? ~ "f-:-{"" 0 AGENT/OWNER DATE ADDRESS TELEPHONE # ADDIESS OWREll tfATtlU PLmtBnJC !lEiHI"! APP.LICA'nON I?~;l ~ C-~ DAD: ~//~/p-' ~TI SL~~~~ fl'-Sfl4. OFtlORlC F~~~L ~#~M)-'/bR'J NEW RELAY REPAIll ImEnOll ).0 ? S- 57 ~.- SAN sml # I iJAn:R Bathtub Sumn Punm !::1l'U I Lavaton Ej ector Toilet Water Softener !NSP~~ON DAm msncnON DAn: nt. Sink Drinking Fountain Sink(othe;o) TT_':_~' W.qterheater Sloo Sink l'::rease Tran Floor Drain Local Waste Laundry Tub Site Drain Disoosal Laundrv Standpioe Dishwasher Catch Basin ** Violat:i~n notes on the revers~ side) I.~ " '