HomeMy WebLinkAbout0029927-Plumbing (interior)/~ CITY OF OSHKOSH N°- 29927
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ! ~~ l~l r/ C.~a~~i! ~r~ PLAN NO.
~~
T
DESIGNER
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 Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
BT _ WH Disp WSoft CBasin
- Lav Sh DW DF -San. Sewer
- WC ~ FDr _ SP Ur -Storm Sewer
-Sink LTub Eject SS _ Water
Other ~ ~~
sr // Q-?j
FEES: Valuation $ Permit Fee Paid $ ll~ Park Dedication $
ISSUED BY Date Final/O.P. ~n - ~C9` ` 7
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
DATE
ADDRESS
TELEPHONE N
STATE OF WISCONSIN )
SS
WINNEBAGO COUNTY )
• A dress
being first duly sworn on oath deposes and says that he is not
a licensed plumber, and that he has applied for a plumbing
permit to the Plumbing Inspector of the City of Oshkosh, to do
plumbing work in a home owned and occupied by him, or a home
that is being constructed that is owned by him, and which will
be occupied by him as his home when completed. That he is not
building said home for the purpose of sale.
This affidavit is made for the purpose of complying with
the provisions of the plumbing code of the City of Oshkosh and
the State of Wisconsin, which provides that all. plumbing work
must be done by a licensed plumber except that the plumbing work
may be done by one who owns and occupies his own home providing
the installation complies with the plumbing code~of the City of
Oshkosh and the State of Wisconsin.
This affiant understands that the Plumbing work authorized
by the permit applied for, must be done only. by this affiant and
that ha cannot employ others who are not licensed plumbers to
assist with the work_
Dated this ~ day of
Subscribed
this a ~
and sworn_to before me
day
19~_.
Notary~ublic, '~Tinnebago ounty, Wisconsin
My Commission Expiress
PLIII~IDII~G P88~T APPLICATION
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owNSR PLD~L'8 ~~
NaTflRE og ~-~. S',~ ~ - L " ~- ~ .
tvRrJ Rtrt.ev ~rosTO r~retrntt -..
~ ~
MATER Bathtub Sum Pu
Lavato E'ector
Toilet Water Softener
ON DATE INSPECTION DAB Ri.t. Siak Drinkin Fountain
Siak other
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7128 ~ ~ ~O W to he ter Slo Sink
(( ease Tra
C
L Floor Drain Local Waste
~,/ ~ g/~3 Laundry Tu Site Drain
~l Dis osal Laundr Stand i e
~~ r ~ ~ /R,~ Dishwasher Catch Basin
** Vialaticn notes on ttie reverie side