HomeMy WebLinkAbout0018769-Plumbing (interior)/~ CITY OF OSHKOSH N° 18769
`' PERMIT - APPLICATION AND RECORD
TYPES BL I~G n HTC~ I-I FI FC: I-l PI R~ -/I-C CIrN I-I 7nNINC~ FI nnn PI DIN HFI(~HT
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ADDRESS o?7i2 ~ ~
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OWNER ~jf(,41~/~~ .
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DESIGNER -
USE/NATURE OF WORK ~f=tic/ . ~'f~/1,~~ t~~ll
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BUILDING CONTRACTOR
Size Sq. Ft. ' # R
Foundation ! oms # Stories Height
Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^
Fixtures Switches Rec Type Volts Amps
eptacles Circuits
PLUMBING CONTRACTOR ~"
BT ~ WH ~ Disp
Lav ~/I Sh ~ DW
~WC ___L FDr ~ SP
Sink ~ LTA Eject
Other WSoft CBasin
DF San. Sewer
Ur -Storm Sewer
SS -Water
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qq Cia '
FEES: Valuation $ ~/~ / Permit Fee
ISSUED BY ~ -p-?~/ o~
Paid $ ~~ Park Dedication $
Date ~r ° `' ~6 Final/O. P. ~~ ~C/lam`'
In the performance of this work I agree to perform all wo
SIGNATUR
//~/~///~/' /,{-. AG NT/OWNER
A 1'11'1000~L~ ~ ~ ~1/1/ ~ ///Gv ~. ~ ~ rk pursuan::o rules governing the described construction.
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~~f~~PLUMBING PERMIT APPLICATION
ADDRESS ~ /7/'`~ ~ > DATE ~~-z- ~ `~Q P RMI T ~~ %~s ~~~
OWNER r~ ~'~'~'`- ,~ ~, G~-~e/~ Y' UMBER
NATURE OF WORK ~ 5 ~ ( Y~ ~~ W
L~LaL;
NEW RELAY REPAIR INTERIOR
SAN SEW ~k ~~
WATER athtub Catch Basin
STORM SEW avato Grease Tra
Toilet Sump Pum
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
_ ~ Sink other) Site Drain
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G Shower Laundry tan pipe
Floor Drain Laundry Tray
f ~~~ ~~~11~"C.-Z- ~ emu' ~°
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` Disposal Wat. So tner
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~~' Dishwasher D. Fountain
~+ Wa.ter Heater Ejector
1 ~;` ~ ~ ~ Urinals Future outlets
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** Violation notes on reverse side