HomeMy WebLinkAbout0022991-Plumbing (water heater)~ CITY OF OSHKOSH N°_ 22991
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~'~.~' PLAN NO.
OWNER ~ ~ _ s
DESIGNER
USE/NATUI
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
Volts Amps
- Circuits
PLUMBING CONTRACTOR
BT ~WH
Lav - Sh
WC FDr
-Sink LTub
Other
~
Disp WSoft CBasin
DW DF -San. Sewer
SP Ur -Storm Sewer
-Eject SS -Water
FEES: Valuation $ S-$~3~ ~ o Permit Fee Paid $ ~ ° ~ `~ ~ Park Dedication $
ISSUED BY W Date ~~~ 7- 9~ Final/O
y ~ ~ ~' ~/ I
P
.
.
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE
ADDRESS
S
DATE
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS ~ ~ ~'
OWNER
NATURE OF WORK
DATE ~ - / 7' S/ PERMIT 4~ '~ ~ ~ ~/
PLUMBER S
NEW RELAY REPAIR INTERIOR
SAN SEW ~~ ~k
WATER athtub Catch Basin
STORM SEW avato Grease Tra
Toilet Sum Pum
N CTION DATE INSPECTION DATE Kit Sink Local Waste
~{ ~ Sink other) ~ Site Drain
~ I 1 ~ v~~ ~ ~~ Shower Laundry tan pipe
Floor Drain Laundry Tray
Disposal Wat. So tner
Dishwasher D. Fountain
~ Wa.ter Heater Ejector
Urinals Future outlets
** Violation notes on reverse side