HomeMy WebLinkAbout0002731-Plumbing (repair orders)/~ CITY OF OSHKOSH NQ _ 02731
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~~L ~ 6 ~'S ! L~/~ ~_ PLAN NO.
OWNER I~/1M~~~~ ~ ~
USE/NATURE OF WORK
/~
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles
PLUMBING CONTRACTOR -
-BT ~WH
Lav
WC
Sh
FDr
Volts Amps
Circuits
Disp _ WSoft CBasin
DW _ DF _ San. Sewer_
SP Ur _ Storm Sewer
-Sink LTub -Eject SS Water
Other ~ - /~1. -W ~ / ~-~c o
~~
FEES: Valuation $ b Permit Fee Paid $ ~ Park Dedication $
ISSUED BY / Date Final/O.P. ~„~~
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~' ~ -3c}..
AGENT/OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION ~~73~
PLUMBER DATE l~~/ ~~
/__ ---~
NAME OF OWNER ~n ~ ~--~~lT.~ ADDRESS ~~G ,J6 5',j ~2~
r ~/~
NEW SAN. WATER STORM RELAY SAN. WATER STORM
Main to Curb Main to Curb
Curb to Bld Curb to Bld .
Elect. Pum s Re air
Se tic Tanks
NEW REP. NEW REP. NEW REP.
Bath Tub Gar. Dis osal Catch Basin
Wash Basin Dishwasher Conductors
Water Closet Laundramats Grease C.B.
Sink Water Softener Sum Pum
Water Heater San. Bubblers Bar Wastes
Shower Bath Urinals Ran a Boiler
Floor Drain Dental Cus idors Future Outlets