HomeMy WebLinkAbout0020779-Plumbing (interior)/~ CITY OF OSHKOSH N°_ 20779
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
---------------------------/---~-------------------------------------
ADDRESS_ ~ ~oxo ~GZtc.,~~ ~( PLAN NO.
OWNER ~
DESIGNER
USE/NATURE OF WORK
.f~'..e,u~ S
I
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR I'
Heat ^ A/C ^ Vent ^ Fuel/System ~~ Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ '~ T e
i yP Volts Am s
P
Fixtures Switches Receptacles
I Circuits
PLUMBING CONTRACTOR ~-
~ BT ~ WH ~ Disp ! WSoft CBasin ~
3 Lav t Sh f DW ~; _ DF -San. Sewer
"~ WC ~ FDr ~ SP ~~ _ Ur -Storm Sewer
Sink r
LTub Eject ~ SS Water
D
Other K~ ~~ ''
FEES: Valuation $ ~~OO~. o,,d ~ y Permit Fee Paid $ ~ ~`• d ~ Park Dedication $(j~ C~
ISSUED BY ~ ~-~---E"~^-°y ' Date ~~~~S~g6 Final/O.P. ~ ~~ O ~ [ ~
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNA
ADDRESS
DATE
~~>~~~' ~
TELEPHONE #
PLUMING PERMIT APPLICATION
ADDRESS '~ ~® DATE ~ r1 - ~~ PERMIT~k ~?~/~'
~- PLUMBER '~ ' ~~~
OWNER -
NATURE OF WORK ~-~~ S F
NEW RELAY REPAIR INTERIOR
V~
SAN SEW ~6 ~k
WATER / Bathtub Catch Basin
SEW 3 Lavator Grease Trap
3 Toilet Sum Pum
INSPECTION DATE INSPECTION DATE f Kit. Sink Local Waste
Sink(other) Site Drain
g _3-~
"~ ~ ~`~ / Shower / Laundry Stand Pipe
/ Floor Drain / Laundr Tra
~~ ~ ' 3/° %~ / Dis osal Wat. Softner
Dishwasher D. Fountain
~~ a)l~% ~ / Water Heater Ejector
f/ finals Future outlets
** Violation notes on the reverse side