HomeMy WebLinkAbout0022096-Plumbing (water heater)
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CITY OF OSHKOSH N~
PERMIT - APPLICATION AND RECORD
22096
TYPE: BLDG D HTG D ELEC D PLBG M SIGN D ZONING
FLOOD PLAIN
HEIGHT
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
OWNER
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PLAN NO.
ADDRESS
DESIGNER
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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
New D Change D Temp D
Type_ Volts_ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
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_BT -LWH _Disp
_Lav _Sh _DW
_WC _FDr _SP
_Sink _ L Tub _ Eject
Other
_ WSoft
_DF
_ CBasin
w/'C-
_ San. Sewer
_Ur
_ Storm Sewer
_SS
_ Water
FEES: Valuation $ y /--. ;;... . 0 0 Permit Fee Paid $
ISSUED BY W ~~~. Date
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/0 . c) 0 1/'
1//'/;7/
/ /
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
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DATE
ADDRESS
TELEPHONE #
ADDRESS
OWNE R
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U? 41A~~-- C-~ 1'/
RELAY REPAIR
PLUMBING PERMIT APPLICATION
1ft-- DATE / /.3 /;7/ PERMIT4ft
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34~-r'
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NATURE OF WORK
PLUMBER
-# ~2.2,oo
SAN SEW 4ft 4ft
WATER Bathtub Catch Basin
STORM SEW Lavatorv Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
//7/7/ Sink(other) Site Drain
c!!J1:f Shower Laundry Stand Pipe
Floor Drain Laundrv Tray
Disposal Wat. Softner
Dishwasher D. Fountain
I Water Heater Ejector
TTrinals Future outlets
NEW
INTERIOR
t** Violation notes on the reverse sidet
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