HomeMy WebLinkAbout0019011-Plumbing (code corrections)_CITY OF OSHKOSH N°_ 19011
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~~lE~'~!~ PLAN NO.
OWNER ~~~ ~/
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Class of Const.
# Stories
Height .
Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR ~ ,~~~
- BT _ WH _ Disp WSoft CBasin
- Lav _ Sh DW DF -San. Sewer
- WC FDr SP Ur -Storm Sewer
-Sink LTub -Eject SS Water
Other
o~a / o-c>
FEES: Valuation $ jd~ Permit Fee Paid $ ~l1 / Park Dedication $
ISSUED BY / Date ~S "~'~ ~`~~ Final/O.P.
In the performance of this work I agree to pertorm all work pursuant to rules governing the described construction.
SIGNATURE
Sq. Ft
# Rooms
~ / ~ :~ ~ , r
AGENT/OWNER
ADDRESS
DATE
TELEPHONE #
ADDRES
OWNER
NATURE
PLUMBING PERMIT APPLIC/jATION
TATC •
SAN SEW ~~ ~k
WATER Bathtub Eatch Basin
SEW Lavator Grease Trap
Toilet Sum Pum
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other Site Drain
Shower Laundry Stand Pipe
Floor Drain Laundr Tra
Dis osal Wat. Softner
Dishwasher D. Fountain
Water Heater Effector
'pals Future outlets
** Viola ion note on the reverse side
n1Ew RELAY REPAIR INTERIOR