HomeMy WebLinkAbout0024324-Plumbing (connect city water)CITY OF OSHKOSH N4 24324
n PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ? PLAN NO.
OWNER ~-~-
USE/NATURE OF WORK
Gr. C~
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 P - "`
- DW DF ~ San. Sewer ~ 9 J C-
SP Ur _ Storm Sewer
-Eject SS l Water ~ ~-
W
FEES: Valuation $ ~~ ~ ^ Permit Fee Paid $ ~A ' ~ G Park Dedication $
ISSUED BY ~ 'tom Date ~ ` ~~ ~~l Final/O. P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~ ~ ~Pj _ 9/
(~ (''~' AGENT/OWNER '! I~ ~ ~/ DATE
ADDRESS /~ L ..~ / G U r~S C I ~.S~'I OS~ W ~ 7I y a3 /' ~~ 9/
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS
~1 p ~ PERMIT
OWNE R
NATURE
sAN sEw J 4k ~~
WATER athtub Catch Bzsin
STORM SEW avato Grease Tra
Toilet Sump Pump
N PE TIO DATE INSPECTION DATE Kit Sink Local Waste
S ~ ~ _ l~ -~j Sink other) Site Drain
~ ~ / ~
~
~
1 Shower Laundry tan pipe
3
~
_ j j
J
~ Floor Drain Laundry Tray
S/L~ (o - f 5~ ~//,
~s°~j~~ Disposal Wat. So tner
/ Dishwasher D. Fountain
Wa.t2r Heater Ejector
Urinals Future outlets
** Violation notes on reverse side
NEW RELAY REPAIR INTERIOR